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Interventional treatment of ureteric stones: A prospective randomized controlled trial on comparison of Ho: YAG laser and pneumatic lithotripsy in children.

Majid A Mohammed*, Firas Shakir Alattar, Abdullah Yousif Altimary

Urolithiasis in pediatric age group is not similar to that of adults, in regard of aetiology, incidence, and disease course. It is very important to apply minimally invasive surgery for those patients due to the possibility of recurrence in the future. General anesthesia is needed in Extracoprporial Shockwave Lithotripsy (ESWL) in children. So, in cases which require multiple ESWL sessions that mean exposure to more risk of general anesthesia? ESWL is not suitable in cases of large size stones, uric acid stones, cysteine stones and stones masked by bony structure. The study included patients who did not pass detected stones after failure of conservative therapy, stone large to be passed, patients with severe pain or patients with single functioning kidney. The statistical approach used chi squared test for categorical variables and t test for continuous variables with a p value of less than 0.05 was considered significant. The study succeeded to include 93 child patients with no loss during the follow up period. They were having a total of 111 stones distributed as 59 in Laser group and 52 in pneumatic group. The results of this study showed that age and sex distribution were similar in both groups. The technology has made it possible to access and treat stone within the ureter easier. Holmium laser lithotripsy work primarily through a photothermal mechanism that causes stone vaporization and had the ability to fragment all stones regardless of composition. Laser lithotripsy is adding to the health care technologies in Basra city with regards to treatment of ureteric stones. The new experience showed a better safety and efficacy although the older pneumatic approach still have an important role in the management of urolithiasis, considering its low cost and longer durability. Background: Aim of this study is to compare the possible two modalities namely Ho: YAG and pneumotic lithotripsy in the setting of health care of Basra/Iraq