WOFAPS 2025 8th World Congress of Pediatric Surgery

Zihao Xu, Gengyu Du, Xiang Yan

Department of Urology, Pediatric Urolith Center, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310000, Zhejiang Province, China

Objective This research aims to explore the efficiency and safety of endoscopic combined intrarenal surgery (Micro-ECIRS) composed of micro-percutaneous nephrolithotomy (Micro-perc) and retrograde intrarenal surgery (RIRS) in the Galdakao-modified supine Valdivia (GMSV) position for a single session for the treatment of complex nephrolithiasis in children.

Materials and methods This study retrospectively reviewed patients aged<18 years who underwent Micro-ECIRS in the GMSV position for renal stones larger than 2 cm under ultrasound guidance between August 2020 to May 2024 at our institution.

Results A total of 23 patients (14 males and 9 females) received Micro-ECIRS for renal stones under ultrasound guidance while adopting the GMSV position. The average stone size was 2.8 cm (range: 2.1–3.8 cm). Among them, 11 patients had left kidney stones, 8 patients had right kidney stones, and 4 patients had bilateral kidney stones. The mean operative time was 64.5 min (range: 50–100 min). The mean hospital stay was 6.2 days (range: 4–10 days). The mean hemoglobin decrease was 7.9 g/L (range: 4.3–13.1 g/L). The total number of kidneys that had complete stone clearance was 11 kidneys at 48 h postoperatively, 17 kidneys at 2 weeks postoperatively, and 19 kidneys at 1 month postoperatively.

Conclusion Our results demonstrate that Micro-ECIRS while patients are in the GMSV position is a safe and effective method for the treatment of complex children nephrolithiasis. However, all children made three hospital visits and received anesthesia three times. Further research is needed to confirm these findings.