Objectives: The treatment of symptomatic lower pole (LP) calculi poses a challenge due to lower clearance rates.
Herein we present our experience with microperc in the treatment of LP renal calculi.
Patients and Methods: We retrospectively evaluated the symptomatic patients with LP renal calculi who underwent microperc between August 2011 and June 2012 from two referral hospitals. Patients were included only in cases of failure after shock wave lithotripsy (SWL) or retrograde intrarenal surgery (RIRS) and according to the patient preference. The percutaneous renal access was performed using the 4.8Fr "all-seeing needle" with the C-arm fluoroscopy or ultrasound guidance in prone position. Stone disintegration was established using a 200 μm holmium:YAG laser fiber.
Results: A total of 21 patients (mean age 37.3±20.1 years) with LP stone underwent microperc. The mean BMI was 28.6 ± 6.0 kg/m2 and the mean stone size was 17.8±5.9 (9-29) mm. The duration of surgery and fluoroscopic screening was 62.8±25.2 minutes and 150.5±92.8 seconds, respectively. The patients were discharged after a mean 37.5±14.4 hours of hospitalization time. The mean hemoglobin drop was 0.8±0.6 (0.1-2.3) g/dL. Conversion to miniperc was necessitated in one patient with loss of vision. Stone free status was achieved in 18 (85.7%) of the patients. Clinically insignificant residual fragments were observed in only one (4.8%). The procedure was failed in two patients (9.5%). A total of 2 minor complications (renal colic requiring stent insertion and urinary tract infection) were observed postoperatively, non severe.
Conclusion: Microperc is a feasible and efficient treatment modality for symptomatic LP calculi. Our results provide that microperc might take a part in case of SWL and RIRS failures or as an alternative to percutaneous nephrolithotomy or RIRS in the treatment of symptomatic LP calculi.
Written by:
Tepeler A, Armağan A, Sancaktutar AA, Silay MS, Penbegul N, Akman T, Hatipoglu NK, Ersoz C, Erdem MR, Akcay M. Are you the author?
Bezmialem Vakif University, Faculty of Medicine, Department of Urology, Aksaray, Istanbul, Turkey, 34096.
Reference: J Endourol. 2012 Aug 8. Epub ahead of print.
doi: 10.1089/end.2012.0422
PubMed Abstract
PMID: 22873714
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