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Scoping review of recent evidence on the management of pediatric urolithiasis: summary of meta-analyses, systematic reviews and relevant randomized controlled trials

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Abstract

This scoping review aimed to evaluate and summarize the recent 10 year pediatric urolithiasis literature with a particular focus on systematic reviews, randomized-controlled trials (RCT) and meta-analysis. The systematic literature search performed on September 1, 2021, restricted to the recent 10 years, focused on pediatric urolithiasis that are RCTs, meta-analysis and systematic reviews. The summarized literature included etiology, diagnostics, medical and surgical management. GRADE criteria are used to evaluate and standardize the reporting of evidence quality. A total of 33 relevant articles were included. The recent high-level studies included topics of genetic and diet association with pediatric stone formation, diagnostic assessment, medical management intervention including medical dissolution and expulsion therapy. The study extended to include the efficacy and safety of extracorporeal lithotripsy, percutaneous nephrolithotomy and retrograde intrarenal surgery. However, evidence quality was ranked “very-low” or “low”. Based on the GRADE criteria downgrading of the quality level was due to heterogeneity and low precision. A majority of the RCTs were categorized as having a “high” to “uncertain” risk of bias. The relevant RCTs, meta-analyses and systematic reviews within the past decade are of low quality. Consequently, the research provided no clear evidence-based recommendations for managing pediatric urolithiasis. More rigorous research and high-quality studies are needed to determine the best practices.

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Author notes

  1. Michael E. Chua and Justin Jin Kyu Kim co-first authors, contributed equally to the work towards completion and revision of the manuscript.

Authors and Affiliations

  1. Division of Urology, The Hospital for Sick Children, Toronto, ON, Canada

    Michael E. Chua, Keara N. De Cotiis, Mandy Rickard, Armando J. Lorenzo & Joana Dos Santos

  2. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Michael E. Chua, Jin Kyu Kim, Keara N. De Cotiis, Mandy Rickard, Armando J. Lorenzo & Joana Dos Santos

  3. Institute of Urology, St. Luke’s Medical Center, Quezon City, Philippines

    Michael E. Chua

  4. Department of Urology, University of New Mexico, Albuquerque, NM, USA

    Jessica M. Ming

  5. Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA

    Keara N. De Cotiis

  6. Division of Urology, Buddhist Tzu Chi General Hospital, New Taipei Branch, New Taipei City, Taiwan

    Stephen S. Yang

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  1. Michael E. Chua
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection and analysis were performed by JKK and MC. The first draft of the manuscript was written by MC and JKK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Michael E. Chua.

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Chua, M.E., Kim, J.K., Ming, J.M. et al. Scoping review of recent evidence on the management of pediatric urolithiasis: summary of meta-analyses, systematic reviews and relevant randomized controlled trials. Pediatr Surg Int 38, 1349–1361 (2022). https://doi.org/10.1007/s00383-022-05190-3

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