Hatipoglu NK et al, 2013: Comparison of Shockwave Lithotripsy and Microperc for Treatment of Kidney Stones in Children
Hatipoglu NK, Sancaktutar AA, Tepeler A, Bodakci MN, Penbegul N, Atar M, Bozkurt Y, Soylemez H, Silay MS, Istanbulluoglu OM, Akman T, Armağan A
Dicle University, Urology, Dicle University of Department of Urology, Diyarbakır, Turkey, 21280
PURPOSE: We aimed to compare the outcomes of microperc and shockwave lithotripsy (SWL) for treatment of kidney stones in children.
PATIENTS AND METHODS: The medical records of 145 patients with opaque and single kidney stones treated with either SWL or microperc under the age of 15 years were retrospectively reviewed. Both groups were compared in terms of fluoroscopy and operation time, re-treatment, complications, success rate, and secondary and total number of procedures.
RESULTS: Microperc and SWL were performed on 37 and 108 pediatric patients, respectively. The mean age of the patients was 5.91±4.03 years (1-15) and 8.43± 4.84 (1-15) years in the SWL and microperc groups, respectively (p=0.004). The mean stone size was 11.32±2.84 (5-20) mm in the SWL group and 14.78±5.39 (6-32) mm in the microperc group (p˂0.001). In the SWL group, 31 (28.7%) patients underwent a second SWL session and 6 (5%) had a third session. Finally, 95 (88%) patients were stone-free at the end of the SWL sessions. In the microperc group, the stone-free rate was 89.2% in a single session (p=0.645). The mean duration of hospitalization was 49.2 ± 12.3 (16-64) hours in the microperc group and 8.4 ± 2.3 (6-10) hours per one session in the SWL group (p= <0.001). The fluoroscopy time was significantly longer in the microperc group compared with the SWL group (147.3±95.3 seconds vs. 59.6±25.9 seconds, p= <0.001). The rate of requirement for an auxiliary procedure was higher in the SWL group than in the microperc group. The overall complication rates for the microperc and SWL groups were 21.6% and 16.7%, respectively (p=0.498).
CONCLUSIONS: The results of our study demonstrate that microperc provides a similar stone-free rate and a lower additional treatment rate compared with SWL in the treatment of kidney stone disease in children.
J Endourol. 2013 May 28. [Epub ahead of print]
PMID:23713511 [PubMed - as supplied by publisher]
"This is the first study comparing the outcomes of SWL and microperc in the treatment of kidney stone in children" and it shows good results with microperc.
Multiple general anesthesia sessions as required for the shockwave treatment are a drawback of this least invasive technique. Unfortunately the authors fail to give information on the characteristics of those 57.4% of children who were stone-free after one SWL session.