Consensus statement addressing controversies and guidelines on pediatric urolithiasis

Purpose: We aimed to investigate controversial pediatric urolithiasis issues systematically, integrating expert consensus and comprehensive guidelines reviews. Methods: Two semi-structured online focus group meetings were conducted to discuss the study's need and content, review current literat...

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Detalhes bibliográficos
Autores: Tokas, T.|||0000-0003-0928-0507, Haid, B.|||0000-0003-1691-7510, Lusuardi, L., Micali, S.|||0000-0003-2121-1897, Ahmed, Kamran, Sarica, K., Güven, S., Tozsin, A., Lendvay, T.S., Silay, S., Mohan, V.C., Cansino, J.R., Saulat, S., Straub, M., Bujons, Anna|||0000-0002-3995-9329, Akgül, B., Samotyjek, J., Ferretti, S., Cavdar, O.F., Ortner, G., Sultan, S., Choong, S., Saltirov, Iliya, Sezer, A., Netsch, C., de Lorenzis, E., Cakir, O.O., Zeng, G., Gozen, A.S., Bianchi, G., Jurkiewicz, B., Knoll, T., Rassweiler, J.
Tipo de documento: artigo
Data de publicação:2024
País:España
Recursos:Universitat Autònoma de Barcelona
Repositório:Dipòsit Digital de Documents de la UAB
Idioma:inglês
OAI Identifier:oai:ddd.uab.cat:323194
Acesso em linha:https://ddd.uab.cat/record/323194
https://dx.doi.org/urn:doi:10.1007/s00345-024-05161-4
Access Level:Acceso aberto
Palavra-chave:ESWL
Guidelines
Metabolic evaluation
PCNL
Pediatric urolithiasis
Ureteroscopy
Descrição
Resumo:Purpose: We aimed to investigate controversial pediatric urolithiasis issues systematically, integrating expert consensus and comprehensive guidelines reviews. Methods: Two semi-structured online focus group meetings were conducted to discuss the study's need and content, review current literature, and prepare the initial survey. Data were collected through surveys and focus group discussions. Existing guidelines were reviewed, and a second survey was conducted using the Delphi method to validate findings and facilitate consensus. The primary outcome measures investigated controversial issues, integrating expert consensus and guideline reviews. Results: Experts from 15 countries participated, including 20 with 16+ years of experience, 2 with 11-15 years, and 4 with 6-10 years. The initial survey identified nine main themes, emphasizing the need for standardized diagnostic and treatment protocols and tailored treatments. Inter-rater reliability was high, with controversies in treatment approaches (score 4.6, 92% agreement), follow-up protocols (score 4.8, 100% agreement), and diagnostic criteria (score 4.6, 92% agreement). The second survey underscored the critical need for consensus on identification, diagnostic criteria (score 4.6, 92% agreement), and standardized follow-up protocols (score 4.8, 100% agreement). Conclusion: The importance of personalized treatment in pediatric urolithiasis is clear. Prioritizing low-radiation diagnostic tools, effectively managing residual stone fragments, and standardized follow-up protocols are crucial for improving patient outcomes. Integrating new technologies while ensuring safety and reliability is also essential. Harmonizing guidelines across regions can provide consistent and effective management. Future efforts should focus on collaborative research, specialized training, and the integration of new technologies in treatment protocols.