Objective: To present our clinical experiences with micropercutaneous nephrolithotomy in the treatment of moderate-sized renal calculi from a single center. Methods: We retrospectively evaluated the patients with moderate-sized renal calculi who underwent micro-percutaneous nephrolithotomy between December 2012 and Septermber 2013. Results: A total of 68 patients and 70 renal units underwent microperc procedure. Mean age of patients was 41.4 ± 18.8. The mean stone size was 122 ± 83 mm². The operations were performed under spinal anesthesia in 89.7% of the patients. Stone-free rate was 95.7 % (67/70). Clinically significant residual fragments were observed in three patients. The average duration of operation and mean fluoroscopy time was 40 ± 23 min and 108 ± 72 s, respectively. The mean postoperative drop in hemoglobin was 0.95 ± 0.7 while no patient required blood transfusion. Patients were discharged after an average hospitalization time of 27.5 ± 12.4 h. A total of 4 complications (5.7%), including urinary tract infection (Clavien I) in one patient and renal colics requiring stent insertion (Clavien IIIa) in three patients, were observed postoperatively. Conclusion: Microperc technique is safe, feasible, and efficacious. We suggest that micro-percutaneous nephrolithotomy should be considered for the treatment of moderate-sized renal stones as an alternative to SWL and RIRS failures and also may be considered even primarily.

The presence of hydronephrosis does not affect success rates and operative time in micro-PNL procedures significantly. Micropercutaneous nephrolithotomy is technically feasible and efficacious both in hydronephrotic and non-hydronephrotic kidneys.

Objective: We aimed to present the technique of combination of standard percutaneous nephrolithotomy (PNL) with microperc for achieving higher success rates without increasing complication rates in the management of complex renal calculi. Material and methods:The patients who underwent microperc procedure as a complementary procedure to standard PNL for complex kidney stones in two reference hospitals between 2013 and 2015, were evaluated retrospectively.Results: All patients underwent a total of two accesses one for standard PNL and one for microperc. The mean stone size was measured as 54.3 mm. The procedures were completed after an average operative time of 88.2 minutes and fluoroscopy time of 5.3 minutes. Stone free status was achieved in 18 cases (78.2%) and small residual fragments (≤4 mm) were detected in 3 cases (13.1%). Complications were seen in three patients (13%) as hemorrhage in one and postoperative fever in two patients. Conclusion:Despite the limitations of this study, the combination of standard PNL and microperc might reduce the complication rates and increase the success rates when treating complex kidney stones. Future prospective and comparative studies are needed.

ÖzetÜretelyal kanserler insanda 4.en sık görülen tümörler olmasına rağmen senkronize bilateral üst üriner sistem üretelyal kanseri (UTUC) oldukça nadir görülmekte-dir. Yüksek riskli unilateral UTUC olan hastalarda radikal nefroüreterektomi (RNU) gold standart tedavi yöntemidir. Fakat senkronize bilateral UTUC için tedavi yön-temi konusunda bir konsensüs mevcut değildir. Hasta ve tümörün değerlendirme-sine göre karar verilmesi önerilmiştir. Bu vakada 53 yaşında senkronize bilateral yüksek riskli UTUC ile başvuran hastaya bilateral nefron koruyucu yöntem (NSS) uygulanmış ve sonuçları ortaya konulmuştur. Anahtar KelimelerSenkronize; Bilateral Üst Üriner Sistem; Ürotelyal Kanser; Tedavi AbstractSynchronous bilateral upper urinary tract urothelial cancer (UTUC) is a very rare form of urothelial cancer. In patients with high-risk unilateral UTUC, radical nephroureterectomy (RNU) is the gold standard treatment. However, there is no consensus on the treatment for synchronous bilateral UTUC. Evaluation of the patient and the tumor is recommended. Bilateral nephron-sparing surgery (NSS) was performed on a 53-year-old patient who presented with high-risk synchronous bilateral UTUC, and the outcome was reported.

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