Recent Literature on the Minimally Invasive Management of Pediatric Urolithiasis
Bibliographic record
Abstract
Although the surgical management of pediatric urolithiasis does not differ significantly from that of adults, there are anatomical and physiological differences that necessitate special considerations. This review aims to summarize the existing high-level evidence (systematic review, meta-analysis, randomized controlled trials) for surgical management of pediatric urolithiasis, with a discussion on different technical tips to make these surgical approaches achievable. A PubMed web-based medical literature search was performed on May 26, 2020, using the search strategy (Pediatric or children) and (urolithiasis or stone) and Urology. The search was limited to meta-analysis, systematic reviews, and randomized controlled trials published in the past 10 years. Only studies that focused on surgical management of pediatric urolithiasis were included. Fifty-seven records were identified and 47 were excluded as these records were duplicates, did not assess surgical management, or were trials that were included in systematic reviews/meta-analyses that were included in this study. Ten studies were included in this review. Depending on the review/trial, the stone-free rate (SFR) had wide ranges for all of the surgical management options assessed (shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy). There are many considerations in choosing the appropriate surgical management for a patient presenting with pediatric nephrolithiasis–SFRs, radiation exposure, and adverse events being some of these features. All three procedures assessed had different characteristics, with advantages and disadvantages unique to each procedure. As each surgical technique for pediatric urolithiasis provides its advantages and disadvantages, surgeons should discuss all options to provide the best-informed decision-making process to a patient or family who may require surgical management of pediatric nephrolithiasis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.005 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".