PERKÜTAN NEFROLİTOTOMİDE BAŞARIYI ETKİLEYEN FAKTÖRLER

Yıl 2020, Cilt: 22 Sayı: 3, 303 - 309, 31.12.2020

Mustafa Karabıçak , Erkan Arslan , Batuhan Ergani , Hakan Türk

https://doi.org/10.24938/kutfd.715099

Öz

Amaç: Çalışmamızda perkütan nefrolitotomide başarıyı etkileyen faktörleri belirlemeyi amaçladık.

Gereç ve Yöntemler: Ocak 2015 ve Ekim 2018 tarihleri arasında böbrek taşı nedeniyle perkütan nefrolitotomi yapılan 260 hastanın verileri retrospektif olarak incelendi. Hastalar postoperatif dönemde taşsızlık açısından bilgisayarlı tomografi ile değerlendirildi. Hastalar postoperatif dönemde taşı olanlar ve taşı olmayanlar olarak iki gruba ayrıldı. Hastaların yaş, cinsiyet, taş tarafı, komplikasyonlar, tranfüzyon oranları ve nefrostomi tüpü kalış süreleri kayıt altına alındı. Her iki grupta taş yerleşim yeri, taş operasyon öyküsü, taş boyutu, taş cilt mesafesi, beden kitle indeksi, operasyon ve skopi süreleri karşılaştırıldı.

Bulgular: Erkek cinsiyetin, taş boyutu ve yerleşiminin, operasyon ve skopi sürelerinin perkütan nefrolitotomi başarısına etki eden faktörler olduğunu belirledik. Yaş, taş tarafı, taş operasyon öyküsü, beden kitle indeksi, taş cilt mesafesi verilerini incelediğimizde istatiksel anlamlı farklılık saptanmadı. Ayrıca nefrostomi tüpü kalış süreleri, komplikasyon ve transfüzyon oranları her iki grupta benzerdi.

Sonuç: Perkütan nefrolitotomi işleminde başarıyı etkileyen faktörler cinsiyet, taş boyutu ve taş lokalizasyonu olarak sıralanabilir. Ayrıca operasyon ve skopi sürelerinin uzun olduğu hastalarda taşsızlık oranlarının azalabileceği akılda tutulmalıdır.

Anahtar Kelimeler

Böbrek taşı, komplikasyon, perkütan nefrolitotomi, taşsızlık durumu

Factors Affecting Success in Percutaneous Nephrolithotomy

Öz

Objective: In this study, we aimed to determine the factors affecting success in percutaneous nephrolithotomy.

Material and Methods: The data of 260 patients who underwent percutaneous nephrolithotomy for renal stone between January 2015 and October 2018 were analyzed retrospectively. The patients were evaluated by computed tomography in terms of stone-free postoperative period. Patients were divided into two groups as those with and without stones in the postoperative period. Age, sex, stone side, complications, transfusion rates and nephrostomy tube stay times were recorded. Stone location, stone operation history, stone size, stone skin distance, body mass index, operation and scopy times were compared in both groups.

Results: We determined that male gender, stone size and location, duration of operation and scopy time were the factors affecting the success of percutaneous nephrolithotomy. When we analyzed age, stone side, history of stone operation, body mass index and stone skin distance, we did not find any statistically significant difference. Nephrostomy tube stay times, complication and transfusion rates were similar in both groups.

Conclusion: Factors affecting success in percutaneous nephrolithotomy can be listed as sex, stone size and stone localization. In addition, it should be kept in mind that stone-free rates may decrease in patients with long operation and scopy times.

Anahtar Kelimeler

Kidney stone, complication, percutaneous nephrolithotomy, stone free rate

Kaynakça

• 1. Akinci M, Esen T, Tellaloğlu S. Urinary stone disease in Turkey: an updated epidemiological study. Eur Urol. 1991;20(3):200-3.
• 2. Matlaga BR, Assimos DG. Changing indications of open stone surgery. Urology. 2002;59(4):490-4.
• 3. Kane CJ, Bolton DM, Stoller ML. Current indications for open stone surgery in an endourology center. Urology. 1995;45(2):218-21.
• 4. Fernström I, Johannson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol. 1976;10(3):257-9.
• 5. Pearle MS, Clayman RV. Outcomes and selection of surgical therapies of stones in the kidney and ureter; Medical and surgical management In: Coe FL, Favus MJ, Pak CYC, Parks JH, Perminger GM, eds. Kidney Stones: Medical and Surgical Management. Philadelphia. Lippincott-Raven, 1996:709-55.
• 6. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol. 2007;51(4):899-906.
• 7. Lee WJ, Smith AD, Cubelli V, Badlani GH, Lewin B, Vernace F et al. Complications of percutaneous nephrolithotomy. AJR Am J Roentgenol. 1987;148(1):177-80.
• 8. Pires C, Machet F, Dahmani L, Irani J, Dore B. Sensitivity of abdominal radiography without preparation compared with computed tomography in the assessment of residual fragments after percutaneous nephrolithotomy. Prog Urol. 2003;13(4):581-4.
• 9. Küpeli B, Gürocak S, Tunç I, Şenocak S, Karaoğlan U, Bozkırlı I. Value of ultrasonography and helical computed tomography in the diagnosis of stone free patients after extracorporeal shock wave lithotripsy. Int Urol Nephrol. 2005;37(2):225-30.
• 10. Wong C, Leveille RJ. Single upper-pole percutaneous access for treatment of> or=5-cm complex branched staghorn calculi: is shockwave lithotripsy necessary? J Endourol. 2002;16(7):477-81. 11. Sahin A, Atsü N, Erdem E, Oner S, Bilen C, Bakkaloğlu M et al. Percutaneous nephrolithotomy in patients aged 60 years or older. J Endourol. 2001;15(5):489-91.
• 12. Turk H, Yoldas M, Suelozgen T, Karabiçak M, Ergani B, Isoglu CS et al. Is percutaneous nephrolithotomy safe for elderly kidney stone patients? J Gerontol Geriatr Res. 2016;5:288. Doi:10.4172/2167-7182.1000288.
• 13. Goldwasser B, Weinerth JL, Carson CC, Dunnick NR. Factors affecting the success rate of percutaneous nephrolithotripsy and the incidence of retained fragments. J Urol. 1986;136(2):358-60.
• 14. Basiri A, Karrami H, Moghaddam SM, Shadpour P. Percutaneous nephrolithotomy in patients with or without a history of open nephrolithotomy. J Endourol. 2003;17(4):213-6. 15. Tuğcu V, Su FE, Kalfazade N, Şahin S, Özbay B, Taşçı AI. Percutaneous nephrolithotomy (PCNL) in patients with previous open stone surgery. Int Urol Nephrol. 2008;40(4):881-4.
• 16. Pearle MS, Nakada SY, Womack JS, Kryger JV. Outcomes of contemporary percutaneous nephrostolithotomy in morbidly obese patients. J Urol. 1998;160(3):669–73.
• 17. Isoğlu S, Süelözgen T, Turk H, Yoldas M, Karabicak M, Ergani B et al. Results of Percutaneous Nephrolithotomy in Morbid Obese Patients. J Urol Surg. 2016;3:80-3.
• 18. Gonulalan U, Akand M, Coban G, Cicek T, Kosan M, Goktas S et al. Skin-to-stone distance has no impact on outcomes of percutaneous nephrolithotomy. Urol Int. 2014;92(4):444-8.
• 19. Turna B, Umul M, Demiyoguran S, Altay B, Nazli O. How do increasing stone surface area and stone configuration affect overall outcome of percutaneous nephrolithotomy? J Endourol. 2007;21(1):34-43.
• 20. Ipek OM, Horasanlı K. Evaluation of the factors affecting percutaneous success and complications of nephrolithotomy. SCIE 2018;29(3):187-93.
• 21. de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R et al. CROES PCNL Study Group. The clinical research office of the endourological society percutaneous nephrolithotomy global study: Indications, complications, and outcomes in 5803 patients. J Endourol. 2011;25(1):11-7.
• 22. Baş E, Koşar A. Perkütan nefrolitotomi işleminde başarıyı, komplikasyonları ve ameliyat süresini etkileyen faktörlerin değerlendirilmesi. SDÜ Sağlık Bilimleri Enstitüsü Dergisi. 2018;2(9):58-64.
• 23. Turk H, Isoglu CS, Karabıcak M, Yoldas M, Ergani B, Süelözgen T et al. Tecrübenin perkütan nefrolitotomi komplikasyonlarına etkisi. Ege Tıp Dergisi. 2016;55(4):163-7.
• 24. Gok A, Gunes ZE, Cıft A, Yucel M, Benlioglu C, Kilic S et al. Perkütan nefrolitotomide başarıyı etkileyen faktörler. Ankara Medical Journal. 2013;13(2):57-61.