İki santimetreden küçük, beden dışı şok dalgalarına dirençli böbrek taşları tedavisinde minimal invaziv Mikro-Perkütan Nefrolitotominin etkinliği ve güvenilirliği

Abstract

Objective:To describe the preliminary results of the largest series of a new modified minimal invasive technique- Micro-percutaneous nephrolithotomy (microperc) for the treatment of renal stone disease.Materials and methods: :A total of 20 patients (mean age: 37.68 ± 17.93 years) with renal stones underwent microperc. After the insertion of 6 Fr ureteral catheter in lithotomy position, the percutaneous renal access was performed with 4.85Fr all-seeing needle to the desired calix under C-arm fluoroscopy. The stone disaggregation was accomplished with 200µ / 365µ Holmium-YAG laser. The perioperative and postoperative findings were retrospectively evaluated.Resuts: The mean BMI was calculated as 26.42 ± 6.99 kg/m2. Average stone size was 18.52 ± 5.98 (9?30) mm. Three of the 20 patients had anatomic abnormalities (1 kyphoscoliosis, 1 horseshoe kidney and 1 pelvis kidney). The mean operation, fluoroscopy, and hospitalization time were 64.73 ± 38.91 minutes, 179.63 ± 95.44 seconds, and 35.1 ± 19.1 hours respectively. No adjacent organ injury or major complication was observed. The mean hemoglobin drop was 1.05±0.73 gr/dl. The overall success rate including CIRF ( 10% ) was 90 %. Steinstrasse was observed in 2 patients and treated with medical treatment. The extravasation of irrigation fluid was observed in one patient and treated with drain placementConclusion: Although our study presents the preliminary results of limited number of cases, MikroPerc is feasible, safe and efficacious minimal invasive treatment modality with low complication and morbidity rate for the treatment of symptomatic under 2 centimeter renal stones. Further comparable studies with large series are needed.Keywords: Renal stone, MicroPerc, SWL, PNL