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A single centre experience comparing miniperc and Shock wave lithotripsy(SWL) for treatment of radioopaque 1-2 cm renal calculi in children :A prospective randomized study
Anup Kumar*, Sanjeev Jha, Mrinal Pahwa, Rohit Kumar, Delhi, India

INTRODUCTION AND OBJECTIVES: A prospective randomized study was performed comparing miniperc and Shock wave lithotripsy(SWL) for treatment of radioopaque 1-2 cm renal calculi in children to evaluate safety and efficacy of these procedures.

METHODS: All the pediatric patients(less than 15 years) with a single radio-opaque renal stone 1-2 cm undergoing treatment between March 2012 and July 2013 in our department were included. Patients were randomized into 2 groups Group A: miniperc was performed under general anaesthesia using 14 Fr Richard Wolf's miniature nephroscope with holmium laser intracorporeal lithotripsy energy;Group B : SWL was performed as a daycare procedure using the electromagnetic lithotripter (Dornier Alpha Compact).The 2 groups were compared statistically regarding patient demographic profile, 3 month stone free rate, retreatment rates, auxiliary procedures, and complications.

RESULTS: 75 patients were enrolled in each group. The mean age was comparable in 2 groups (10.3 years in group A vs 10.7 years in group B;p=0.57) The mean stone size was 12.7 mm in group A vs. 12.9 mm in group B (p= 0.31). The retreatment rate and auxiliary procedure rate were significantly greater in group B as compared to group A (41.3 % vs 2.6% and 14.6% vs 5.3% respectively; p < 0.001). The overall 3 month stone free rate was (71/75)94.6% for group A vs (62/75)82.6% for group B (p=0.03). The mean procedure time and fluoroscopy time were significantly greater in group A as compared to B (65.1 min vs 43.3 min/ session and 157.1 sec vs 63.2 sec/session respectively ;p=0.01 ) . The complication rate was significantly higher in group A as compared to group B (22.6% vs 5.3% respectively ;p=0.01).The blood transfusion rate was given in 10.6% patients in group A vs none in group B(p=0.01).The mean hospital stay was significantly longer in group A as compared to group B(3.7 days vs 7.1 hours respectively;p = 0.01).

CONCLUSIONS: Miniperc is more efficacious than SWL for treatment of radio-opaque renal calculi 1-2 cm in children in terms of higher stone free rate , lesser auxiliary and retreatment rates.However,miniperc resulted in more complications ,operating time , radiation exposure and hospital stay than SWL .

Source of Funding: none


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