title: Comparison of efficacy of laser lithotripter with ultrasonic lithotripter in mini percutaneous nephrolithotomy.
abstract: OBJECTIVE
  The aim of the study was to compare the efficacy of the laser lithotripter with the ultrasonic lithotripter in mini percutaneous nephrolithotomy (miniperc).
  
  
  METHODS
  From June 2013 to January 2014; medical records of 77 consecutive patients who underwent miniperc operation were retrospectively evaluated. Ultrasonic lithotripter was used in 22 patients (Group 1), while laser was used in 55 patients. In the laser group, 22 patients were randomly selected who had same characteristics compared to group 1 (Group 2). Success rate, total operative time, complications according to modified Clavien classification, fluoroscopy time, haemoglobin drop, hospital stays and cost analysis were assessed. Success rates were evaluated on the second postoperative day and after the first month.
  
  
  RESULTS
  Total operative time (p = 0.635) and fluoroscopy time (p = 0.248) were not significantly different between the two groups. In the laser group, the success rate (81.8%) was notably more than in the ultrasonic lithotripter group (68.2%) but there was no statistically significance (p = 0.296). Ten reusable ultrasonic probe were used for 22 patients, due to thinness and sensitiveness of the probe. Conversely, one single laser fiber (550 micron) was used for 22 patients. When the cost analysis of lithotripsy was considered, the cost per case was 190 dollar in group 1 and 124 dollar in group 2. (p = 0.154) Complication rate, hospital stay and haemoglobin drop were similar in both groups.
  
  
  CONCLUSIONS
  Laser lithotripsy seems to be more cost effective than ultrasonic lithotripsy for miniperc but larger number of patients are required to confirm this estimation.
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Istanbul. drfakbulut@hotmail.com.
authors.forename: Fatih
authors.initials: F
authors.lastname: Akbulut
authors.forename: Onur
authors.initials: O
authors.lastname: Kucuktopcu
authors.forename: Emre
authors.initials: E
authors.lastname: Kandemir
authors.forename: Erkan
authors.initials: E
authors.lastname: Sonmezay
authors.forename: Abdulmuttalip
authors.initials: A
authors.lastname: Simsek
authors.forename: Burak
authors.initials: B
authors.lastname: Ucpinar
authors.forename: Faruk
authors.initials: F
authors.lastname: Ozgor
authors.forename: Gokhan
authors.initials: G
authors.lastname: Gurbuz
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D005471:Fluoroscopy / Q000191:economics; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000191:economics / Q000601:surgery / Q000628:therapy*; D007902:Length of Stay / Q000191:economics; D017602:Lithotripsy, Laser / Q000191:economics; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000191:economics; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey; D014465:Ultrasonics / Q000191:economics