title: Flexible ureteroscopy and lasertripsy (FURSL) for paediatric renal calculi: results from a systematic review.
abstract: OBJECTIVE
  To understand the role, safety and efficacy of flexible ureterorenoscopy and lasertripsy (FURSL) for paediatric renal stones.
  
  
  METHODS
  A systematic review was conducted using studies identified by a literature search between January 1990 and March 2014. All English language articles reporting on a minimum of five patients≤18-years old, treated with flexible ureteroscopy and lasertripsy for stone disease were included.
  
  
  RESULTS
  A total of six studies (282 patients) were reported, with a mean age of 7.3 years (range 0.25-17 years). The stone sizes ranged from 1 to 30 mm. The mean stone-free rate across the three studies was 85.5% (range 58.0-93.0%) after initial ureteroscopy, with a postoperative stent inserted in 81.8% (range 66.7-98.0%). There were a total of 35 complications (12.4%), with the most severe complication being a Clavien class III (five ureteral injuries, one urinoma). There were no deaths in any of the studies.
  
  
  CONCLUSIONS
  The present review shows that FURSL for management of renal calculi in the paediatric population is an effective and safe procedure. To ensure that outcomes keep on improving, these procedures should be undertaken by experienced surgeons who are familiar with the difficulties encountered in the paediatric population.
authors.affiliation: Department of Urology, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK.
authors.forename: H
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Paediatric Surgery, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK.
authors.forename: S
authors.initials: S
authors.lastname: Griffin
authors.affiliation: Department of Urology, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK. Electronic address: bhaskarsomani@yahoo.com.
authors.forename: B K
authors.initials: BK
authors.lastname: Somani
mesh_terms: D002648:Child; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis* / Q000628:therapy*; D017602:Lithotripsy, Laser / Q000379:methods*; D012720:Severity of Illness Index; D018666:Ureteroscopy / Q000379:methods*
keywords: Calculi; Flexible ureteroscopy; Laser; Pediatrics; Stone