Micropercutaneous nephrolithotripsy: initial experience

INTRODUCTION: For small renal calculi (< 2 cm) the currently available treatment options include extracorporeal shockwave lithotripsy (ESWL), retrograde intrarenal surgery (RIRS) and standard/mini percutaneous nephrolithotomy (PNL). A new method, microperc, has therefore been developed, in which a smaller tract size and smaller instruments were used. AIM: To present our clinical experiences with micropercutaneous nephrolithotripsy (microperc) in the treatment of small renal calculi. MATERIAL AND METHODS: We retrospectively evaluated patients with small renal calculi who underwent microperc between February and June 2013. A 4.8 Fr ‘all-seeing needle’ was used to achieve percutaneous renal access with the C-arm fluoroscopy guidance in the prone position. Holmium: YAG laser 272 µm fiber was used for stone fragmentation. RESULTS: A total of 20 patients underwent the microperc procedure. The mean age of the patients was 46.5 ±13.8 years. The mean stone size was 13 ±3 mm. The stone-free rate (SFR) was 90% (18/20). Two patients had clinically significant residual fragments (≥ 4 mm). The mean operation and fluoroscopy times were 107.5 ±37 min and 45 ±40 s respectively. The mean postoperative drop in hemoglobin was 1.2 ±0.9 g/dl, and 1 patient required blood transfusion. The patients were discharged after an average hospitalization of 1.4 ±0.8 days. Two complications, urinary tract infection and blood loss requiring blood transfusion, were observed in 2 patients postoperatively. CONCLUSIONS: We suggest that microperc should be considered for the treatment of small renal stones.