Initial report of microperc in the treatment of pediatric nephrolithiasis

Abstract

Background/Purpose: To report the first technical feasibility and safety of microperc in the treatment of pediatric nephrolithiasis. Methods: A multicenter prospective trial was initiated and microperc was performed in 19 children from four different centers. In all cases, 4.85-Fr all-seeing needle was used to access the collecting system under direct vision. Stone fragmentation was performed using a 200-mu m holmium: YAG laser fiber either through the same needle sheath or an 8-Fr microsheath. Patient-and procedure-related factors and perioperative and postoperative parameters were analyzed. Results: The mean age of the children was 7.5 +/- 4.4 years. Mean stone size was 14.8 +/- 6.8 mm. Conversion to Mini-PNL was required in two patients because of optical default in one and the high stone burden in the other. The mean hospital stay was 1.8 +/- 0.8 days and the mean hemoglobin decrease was 0.1 mg/dl. The overall stone-free rate at 1 month was 89.5%. In one patient with obstructed ureteropelvic junction, intravasation of the irrigation fluid has led to abdominal distention and managed with percutaneous drainage intraoperatively. No other postoperative complication was recorded and no ancillary procedure was required. Conclusions: Microperc is a safe and effective procedure in the treatment of pediatric kidney stones. (C) 2013 Elsevier Inc. All rights reserved.