title: ROLE OF MICROPERC IN MINIMAL INVASIVE EXTRACTION OF Renal STONES IN CHILDREN.
abstract: BACKGROUND
  Microperc using all-seeing needle is associated with reduced tract-related morbidity.
  
  
  OBJECTIVE
  The purpose of this study was to examine the effectiveness and safety of microperc in children.
  
  
  METHODS
  From July 2010 to August 2014, a total of 17 children with renal stones underwent microperc at Muljibhai Patel Urological Hospital, Nadiad, India. Renal access was achieved through 4.85-Fr (16 gauge) all-seeing needle (PolyDiagnost, Pfaffenhofen, Germany). and fragmentation with 200 µm holmium:YAG laser fiber. The patient's demographic data, clinical features, operating time, hemoglobin drop, stone clearance, complications (Clavien-Dindo), and length of hospital stay were prospectively studied.
  
  
  RESULTS
  A total of 17 patients with a median age of 9 years were studied. The stone size ranged from 5.3mm to 24.9mm. The median operative time was 40 minutes. The median decrease in haemoglobin was 1.2 mg/dl. The stone-free rate at first postoperative day and at the first month after the procedure were 82.4% and 88.2% respectively. The mean hospital stay was 56.4 hours. None of the patients required blood transfusion. An overall success rate of 94.1% was achieved at median follow-up of 4 months. Comparing small size stones (< 1cm) and moderate size stone (1-3cm); the immediate clearance rates were 100% and 75% respectively (p=0.331). There was no statistically significant difference in the operating time (40 vs 43mins; p=0.592), haemoglobin drop (0.85 vs 1.25 g/dl; p=0.595) and the length of hospital stay. One patient in each group had conversion to miniperc to remove residual stone fragment. There was one minor intra-operative pelvic perforation (Clavien II). There were two postoperative complications in patients with moderate stone; one of the patients had right lower lobar pneumonia and the other had colic pain and both cases were managed conservatively (Clavien I).
  
  
  CONCLUSIONS
  This study has demonstrated that microperc is a safe and effective procedure in the extraction of small to medium size renal stones in children.
authors.affiliation: Department of Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: A A
authors.initials: AA
authors.lastname: Nasir
authors.affiliation: Department of Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: S K
authors.initials: SK
authors.lastname: Mishra
authors.affiliation: Department of Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: A
authors.initials: A
authors.lastname: Ahmadi
authors.affiliation: Department of Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: V
authors.initials: V
authors.lastname: Murali
authors.affiliation: Department of Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: V B
authors.initials: VB
authors.lastname: Kori
authors.affiliation: Department of Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: V B
authors.initials: VB
authors.lastname: Kori
authors.affiliation: Department of Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: R B
authors.initials: RB
authors.lastname: Sabnis
authors.affiliation: Department of Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: M R
authors.initials: MR
authors.lastname: Desai