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ROLE OF MICROPERC IN MINIMAL INVASIVE EXTRACTION OF Renal STONES IN CHILDREN
A A Nasir1, S K Mishra1, A Ahmadi1
1Department of Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Background:
Microperc using all-seeing needle is associated with reduced tract-related morbidity.
Aim & Objectives:
The purpose of this study was to examine the effectiveness and safety of microperc in children.
Patients & Methods:
From July 2010 to August 2014, a total of 17 children with renal stones underwent microperc at Muljibhai Patel Urological Hospital, Nadiad, India. Renal access was achieved through 4.85-Fr (16 gauge) all-seeing needle (PolyDiagnost, Pfaffenhofen, Germany). and fragmentation with 200 µm holmium:YAG laser fiber. The patient's demographic data, clinical features, operating time, hemoglobin drop, stone clearance, complications (Clavien-Dindo), and length of hospital stay were prospectively studied.
Results:
A total of 17 patients with a median age of 9 years were studied. The stone size ranged from 5.3mm to 24.9mm. The median operative time was 40 minutes. The median decrease in haemoglobin was 1.2 mg/dl. The stone-free rate at first postoperative day and at the first month after the procedure were 82.4% and 88.2% respectively. The mean hospital stay was 56.4 hours. None of the patients required blood transfusion. An overall success rate of 94.1% was achieved at median follow-up of 4 months. Comparing small size stones (< 1cm) and moderate size stone (1-3cm); the immediate clearance rates were 100% and 75% respectively (p=0.331). There was no statistically significant difference in the operating time (40 vs 43mins; p=0.592), haemoglobin drop (0.85 vs 1.25 g/dl; p=0.595) and the length of hospital stay. One patient in each group had conversion to miniperc to remove residual stone fragment. There was one minor intra-operative pelvic perforation (Clavien II). There were two postoperative complications in patients with moderate stone; one of the patients had right lower lobar pneumonia and the other had colic pain and both cases were managed conservatively (Clavien I).
Conclusion:
This study has demonstrated that microperc is a safe and effective procedure in the extraction of small to medium size renal stones in children.
Insights
Microperc, a minimally invasive kidney stone removal technique, proved safe and effective for pediatric patients. This procedure offers reduced morbidity and high stone-free rates in children with small to medium-sized renal stones.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Nephrolithiasis Treatment
Background:
- Microperc (percutaneous nephrolithotomy) using an all-seeing needle is linked to decreased tract-related complications.
- Pediatric renal stone management requires tailored, minimally invasive approaches.
Purpose of the Study:
- To evaluate the efficacy and safety of the microperc technique for treating renal stones in children.
- To assess microperc outcomes in a pediatric population.
Main Methods:
- A prospective study of 17 children with renal stones treated with microperc between July 2010 and August 2014.
- Utilized a 4.85-Fr all-seeing needle for access and a holmium:YAG laser for fragmentation.
- Collected data on demographics, operative details, stone clearance, complications (Clavien-Dindo), and hospital stay.
Main Results:
- The median age of patients was 9 years, with stone sizes ranging from 5.3mm to 24.9mm.
- Achieved an 88.2% stone-free rate at one month post-procedure, with an overall success rate of 94.1%.
- Reported a low complication rate, including one minor intra-operative perforation (Clavien II) and two managed conservatively (Clavien I).
Conclusions:
- Microperc is a safe and effective minimally invasive option for pediatric renal stone extraction.
- The procedure demonstrates high stone-free rates and acceptable complication profiles in children.
- Supports the use of microperc for small to medium-sized renal calculi in pediatric patients.
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