title: Factors affecting complication rates of ureteroscopic lithotripsy in children: results of multi-institutional retrospective analysis by Pediatric Stone Disease Study Group of Turkish Pediatric Urology Society.
abstract: OBJECTIVE
  We evaluated factors affecting complication rates of ureteroscopy for pediatric ureteral calculi.
  
  
  METHODS
  We retrospectively evaluated 642 children who underwent ureteroscopy at 16 Turkish centers between 2000 and 2010. Semirigid ureteroscopy was used with various calibers to treat 670 ureteral units in 660 sessions. Complications were evaluated according to the Satava and Clavien classification systems. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates.
  
  
  RESULTS
  A total of 367 females and 265 males were studied. Mean±SD patient age was 90.2±51.4 months (range 4 to 204). Mean±SD stone size, operative time and postoperative hospital stay were 8.9±4.7 mm, 45.8±23.8 minutes and 1.8±2.8 days, respectively. At a mean±SD followup of 13.3±17.6 months 92.8% of patients were stone-free and efficacy quotient was 90.3%. Complications, which occurred in 8.4% of patients (54 of 642), were intraoperative in 25 (Satava grade I to II in 22), early postoperative in 25 (Clavien grade I to II in 23) and late postoperative in 4 (all grade III). While operative time, age, institutional experience, orifice dilation, stenting and stone burden were statistically significant on univariate analysis, multivariate analysis revealed that operative time was the only statistically significant parameter affecting the complication rate.
  
  
  CONCLUSIONS
  Semirigid ureteroscopy is effective, with a 90% stone-free rate and efficacy quotient. Most complications are low grade and self-limiting. Our results confirm that prolonged operative time is an independent predictor of complications, and should be considered when choosing and performing the treatment modality.
authors.affiliation: Department of Urology, Uludag University Faculty of Medicine, Bursa, Turkey. hasedogan@yahoo.com
authors.forename: Hasan Serkan
authors.initials: HS
authors.lastname: Dogan
authors.forename: Bulent
authors.initials: B
authors.lastname: Onal
authors.forename: Nihat
authors.initials: N
authors.lastname: Satar
authors.forename: Cem
authors.initials: C
authors.lastname: Aygun
authors.forename: Mesut
authors.initials: M
authors.lastname: Piskin
authors.forename: Orhan
authors.initials: O
authors.lastname: Tanriverdi
authors.forename: Serhat
authors.initials: S
authors.lastname: Gurocak
authors.forename: Levent Mert
authors.initials: LM
authors.lastname: Gunay
authors.forename: Berk
authors.initials: B
authors.lastname: Burgu
authors.forename: Ender
authors.initials: E
authors.lastname: Ozden
authors.forename: Oktay
authors.initials: O
authors.lastname: Nazli
authors.forename: Erim
authors.initials: E
authors.lastname: Erdem
authors.forename: Selcuk
authors.initials: S
authors.lastname: Yucel
authors.forename: Aykut
authors.initials: A
authors.lastname: Kefi
authors.forename: Deniz
authors.initials: D
authors.lastname: Demirci
authors.forename: Nihat
authors.initials: N
authors.lastname: Uluocak
authors.forename: Ibrahim Atilla
authors.initials: IA
authors.lastname: Aridogan
authors.forename: Tahsin
authors.initials: T
authors.lastname: Turunc
authors.forename: Veli
authors.initials: V
authors.lastname: Yalcin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kilinc
authors.forename: Kaya
authors.initials: K
authors.lastname: Horasanli
authors.forename: Mustafa Ozgur
authors.initials: MO
authors.lastname: Tan
authors.forename: Tarkan
authors.initials: T
authors.lastname: Soygur
authors.forename: Saban
authors.initials: S
authors.lastname: Sarikaya
authors.forename: Hakan
authors.initials: H
authors.lastname: Kilicarslan
authors.forename: Burak
authors.initials: B
authors.lastname: Turna
authors.forename: Hasan Erdal
authors.initials: HE
authors.lastname: Doruk
authors.forename: Serdar
authors.initials: S
authors.lastname: Tekgul
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008096:Lithotripsy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D012189:Retrospective Studies; D014421:Turkey; D014514:Ureteral Calculi / Q000628:therapy*; D018666:Ureteroscopy / Q000009:adverse effects*