Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?

KAYA, Taylan Özgür; İSEN, Kenan; HATİPOĞLU, Namık Kemal; DEDEOĞLU, Serhat; AĞAOĞLU, İsrafil

Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?

Kenan İSEN, (Diyarbakır Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Diyarbakır, Türkiye)

İsrafil AĞAOĞLU, (Özel Park Hastanesi, Üroloji Kliniği, Mardin, Türkiye)

Serhat DEDEOĞLU, (Diyarbakır Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Diyarbakır, Türkiye)

Namık Kemal HATİPOĞLU, (Diyarbakır Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Diyarbakır, Türkiye)

Taylan Özgür KAYA (Diyarbakır Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Diyarbakır, Türkiye)

Türk Üroloji Dergisi/Turkish Journal of Urology

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Yıl: 2011 Cilt: 37 Sayı: 4 Sayfa Aralığı: 311 - 315 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?

Öz:

Amaç: Büyük çaplı üst üreter taşı olan olgularda standart perkütan nefrolitotripsinin (PNL) etkinliğini değerlendirmek.Gereç ve yöntem: Eylül 2009 ile Mart 2011 tarihleri arasında 27 hastaya böbrek taşı ve/veya büyük çaplı üst üreter taşı nedeniyle standart PNL uygulandı. Taşların yerleşimi üreteropelvik bileşke ile 4. lomber vertebra arasında idi. Taş yükü, başarı oranı, operasyon süresi, giriş, hemoglobin düşüşü, analjezik gereksinimi, serum kreatinin düzeyi, hastanede kalış süresi ve komplikasyonlar değerlendirildi. Bulgular: Ortalama taş yükü 374.1 mm² ve operasyon süresi 73.3 dakika idi. Genel başarı oranı %85.1 idi. Hastaların 26sına (%96.2) tek giriş ve 1ine (%3.8) ise iki giriş yapıldı. Olguların 3ünde (%10.7) üst kaliksten, 21inde (%75) orta kaliksten, 4ünde (%14.3) alt kaliksten giriş sağlandı. Operasyon öncesi serum kreatinin düzeyi 1.0±0.2 mg/dL ve operasyon sonrası serum kreatinin düzeyi ise 1.1±0.3 mg/dL idi (p>0.05). Ortalama hemoglobin düşüşü 2.1 mg/dL, ağrı kesici gereksinimi 230.7 mg ve hastanede kalış süresi 2.3 gün idi. Genel komplikasyon oranı %29.6 idi. Bir (%3.7) hastada açık cerrahi gereksinimi oldu. Kan transfüzyon oranı %11.1 idi. Ateş (>38.5°C), pelvik perforasyon ve uzamış idrar drenajı sırasıyla 2 (%7.4), 1 (%3.7), 1 (%3.7) olguda gözlendi. Yardımcı işlemler olguların 4ünde (%14.9) gerekli oldu (2 olguda vücut dışı şok dalga tedavisi, 1 olguda üreteroskopi ve 1 olguda double J stent uygulaması).Sonuç: PNL büyük çaplı üst üreter taşlarının tedavisinde hala kabul edilebilir bir işlemdir. Tecrübeli ellerde güvenle yapılabilir ve iyi sonuçlar alınabilir.

Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Cerrahi

Perkütan nefrolitotripsi büyük çaplı üst üreter taşları için hala kabul gören bir tedavi şeçeneği midir?

Öz:

Objective: To assess the efÀcacy of standard percutaneous nephrolithotripsy (PNL) in patients with large upper ureteric stones. Materials and methods: Between September 2009 and March 2011, 27 patients underwent standard PNL for renal stones or large upper ureteric stones. The stones were located between the ureteropelvic junction and 4th lumbar vertebra. Stone burden, success rate, operating time, access, hemoglobin drop, analgesic requirement, serum creatinine level, hospital stay, and complications were evaluated. Results: The mean stone burden was 374.1 mm2 and the operating time was 73.3 min. The total success rate was 85.1%. Single access was used in 26 (96.2%) patients and a second access was necessary in 1 (3.8%) patient. Access was achieved to the upper, middle, and lower calix in 3 (10.7%), 21 (75%), and 4(14.3%) patients, respectively. The pre- and postoperative serum creatinine levels were 1.0±0.2 and 1.1±0.3 mg/dL, respectively (p>0.05). The mean hemoglobin decrease was 2.1 mg/dL, analgesic requirement was 230.7 mg, and hospital stay was 2.3 days. The total complication rate was 29.6%. Open surgery was required in 1 (3.7%) patient. The blood transfusion rate was 11.1%. Fever (>38.5°C), pelvic perforation, and prolonged urinary drainage were seen in 2 (7.4%), 1 (3.7%), and 1 (3.7%) patient, respectively. Auxiliary procedures were needed in 4 (14.9%) patients (extracorporeal shock wave lithotripsy in 2, and ureteroscopy and double J stenting in 1 patient each).

Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Cerrahi

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

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APA	İSEN K, AĞAOĞLU İ, DEDEOĞLU S, HATİPOĞLU N, KAYA T (2011). Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?. , 311 - 315.
Chicago	İSEN Kenan,AĞAOĞLU İsrafil,DEDEOĞLU Serhat,HATİPOĞLU Namık Kemal,KAYA Taylan Özgür Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?. (2011): 311 - 315.
MLA	İSEN Kenan,AĞAOĞLU İsrafil,DEDEOĞLU Serhat,HATİPOĞLU Namık Kemal,KAYA Taylan Özgür Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?. , 2011, ss.311 - 315.
AMA	İSEN K,AĞAOĞLU İ,DEDEOĞLU S,HATİPOĞLU N,KAYA T Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?. . 2011; 311 - 315.
Vancouver	İSEN K,AĞAOĞLU İ,DEDEOĞLU S,HATİPOĞLU N,KAYA T Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?. . 2011; 311 - 315.
IEEE	İSEN K,AĞAOĞLU İ,DEDEOĞLU S,HATİPOĞLU N,KAYA T "Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?." , ss.311 - 315, 2011.
ISNAD	İSEN, Kenan vd. "Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?". (2011), 311-315.

APA	İSEN K, AĞAOĞLU İ, DEDEOĞLU S, HATİPOĞLU N, KAYA T (2011). Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?. Türk Üroloji Dergisi/Turkish Journal of Urology, 37(4), 311 - 315.
Chicago	İSEN Kenan,AĞAOĞLU İsrafil,DEDEOĞLU Serhat,HATİPOĞLU Namık Kemal,KAYA Taylan Özgür Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?. Türk Üroloji Dergisi/Turkish Journal of Urology 37, no.4 (2011): 311 - 315.
MLA	İSEN Kenan,AĞAOĞLU İsrafil,DEDEOĞLU Serhat,HATİPOĞLU Namık Kemal,KAYA Taylan Özgür Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?. Türk Üroloji Dergisi/Turkish Journal of Urology, vol.37, no.4, 2011, ss.311 - 315.
AMA	İSEN K,AĞAOĞLU İ,DEDEOĞLU S,HATİPOĞLU N,KAYA T Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?. Türk Üroloji Dergisi/Turkish Journal of Urology. 2011; 37(4): 311 - 315.
Vancouver	İSEN K,AĞAOĞLU İ,DEDEOĞLU S,HATİPOĞLU N,KAYA T Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?. Türk Üroloji Dergisi/Turkish Journal of Urology. 2011; 37(4): 311 - 315.
IEEE	İSEN K,AĞAOĞLU İ,DEDEOĞLU S,HATİPOĞLU N,KAYA T "Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?." Türk Üroloji Dergisi/Turkish Journal of Urology, 37, ss.311 - 315, 2011.
ISNAD	İSEN, Kenan vd. "Is percutaneous nephrolithotripsy still a reasonable treatment option for large upper ureteric stones?". Türk Üroloji Dergisi/Turkish Journal of Urology 37/4 (2011), 311-315.