243 / 330
243
19–22 APRIL, 2017, BARCELONA, SPAIN
Factors which influenced blood transfusion in “group A” were small age (p =0.02), Preop mean Hb
(p=0.009), preop Hematocrit(p=0.01), and mean operative time (p=0.01) whereas in “Group B” pre
operative hemoglobin was the only influencing factor (p= 0.001)
In group A Laser was used in 59% and pneumatic lithoclast in 28.5% whereas in Group B laser
used in 49.3% and pneumatic lithoclast in 33.7 %. Complications in Group A were 15.7% vs 24% in
Group B. Majority were in Clavein grade I and II. Chest tube was placed in 2/83 patients in Group B.
CONCLUSIONS
Mini PCNL is safe and effective with good outcome and acceptable complication rate in both the
groups. Increased stone burden in Group B reduced the clearance rate in monotherapy. This is one
of the largest series of mini PCNL in children.
10:53–11:02
Discussion
S22-8 (P without presentation)
HIGH POWERED LASERTRIPSY FOR URETERIC STONE
Sadaf ABA UMER KODWAVWALA, Sajid SULTAN, Bashir AHMED, Hina YOUSUF,
Firasat MAJID and Adeeb Ul Hassan RIZVI
Sindh Institute of Urology & Transplantation, Philip G. Ransley Department of Paediatric Urology, Karachi, PAKISTAN
PURPOSE
To evaluate the safety and outcome of ureterorenoscopy(URS) and high power Holmium:YAG laser
lithotripsy for Ureteric stones in children.
MATERIAL AND METHODS
Medical records of patients who underwent ureterorenscopy and laser lithotripsy using high power
holmium: YAG laser (80 watt) for Ureteric stones between September 2015-2016 were reviewed
retrospectively for mean age,gender,clinical presentation,laterality and location.Stone volume was
assessed by length (cm)xwidth (cms)=volume in cm
2
.Outcome as stone clearance was evaluated
for stone volume,location and number of sessions required.
RESULTS
107 units in 99 patients with mean age 5.6+/-3.8 years and M:F 1.8:1. 75% were radio opaque.
Eighty four (78.5%) were distal,13(12.1%) middle and 10(9.3%) were in proximal ureter.Seventy
four percent (79/107) stones were cleared in single session. Ninty two percent(22/24)cleared in two
sessions.The mean volume of stone cleared in single session and two session is 0.67+/-0.4 cm
2
and 0.95+/-0.53 cm
2
respectively(p=0.006).
In distal ureter 75%(63/84) cleared in single session and 94%(16/17) cleared in 2 sessions. In mid
ureter 84.6%(11/13) cleared in single session and the other 2 cleared in 2
nd
session.In proximal
ureter 50%(5/10)cleared in single session and 4/4 cleared in 2 sessions.
Of the 107, 102 (95.3%) with mean stone volume of 0.74+/-0.44 cm
2
cleared in 1.23+/-0.44 ses-
sions. Four are due for 2
nd
session and one for third session. Forty four units (41%) required post
stenting.Over all complication rate was 27% with majority of clavien Grade I and II.
CONCLUSIONS
There was an excellent clearance for ureteric stone with high power Ho:YAG laser. Increasing stone
volume was the most important factor in requiring more number of sessions for clearance. Less
proximal Ureteric stones were cleared in single sessions. Limitations are retrospective study and
small number in mid and proximal ureter.