Micropercutaneous Nephrolithotomy in the Treatment of Moderate-Size Renal Calculi

Purpose: We present our initial experience with microperc in patients with moderate-size renal calculi. Patients and Methods: A retrospective analysis of 30 patients (male 14, female 16) with moderate-size (1-3 cm) kidney stones who underwent microperc between August 2011 and July 2012 was performed. The demographic values, perioperative and postoperative measures including age, stone size and location, body mass index, operative and fluoroscopy time, hemoglobin decrease, success and complication rates were prospectively recorded into a patient entry system. Results: The average stone size was 17.9 +/- 5.0mm (10-30 mm). The mean age of the patients was 41.5 +/- 18.2 years (range 3-69 years). The duration of the operation was calculated as 63.5 +/- 36.8 minutes (range 20-200 min). Mean fluoroscopic screening time was 150.5 +/- 90.4 seconds (range 45-360 seconds). The patients were discharged after a mean hospitalization period of 35.5 +/- 18.6 hours (range 14-96 hours). An overall success rate of 93% (including 10% of insignificant residual fragment rate) was achieved. In the follow-up, residual stone fragments were detected in two (7%) patients. Conversion to miniperc was necessitated in three (10%) patients. The mean hemoglobin drop was found to be 1.1 +/- 0.8mg/dL (range 0-2.8mg/dL). Complications were observed in five (13.3%) patients. Conclusions: Our initial results provide that microperc is a feasible, safe, and efficacious treatment modality for moderate-size kidney stones as well as small ones with its minimally invasive nature. Technical refinements are needed to achieve better results and overcome the limitations of technique.