Ahmet KİPER, M. Abdurrahim İMAMOĞLU, Adnan GÜCÜK, Orhan YİĞİTBAŞI, Can TUYGUN

Üreter alt uç taşlarının tedavisinde pulsed dye laser litotripsi ile pnömotik litotripsi sonuçlarının karşılaştırılması

Amaç: Distal üreler taşlarının tedavisinde dye laser ve pnömotik litotripsi metodlarının başarı oranları ve güvenirliğinin karşılaştırılması. Materyal ve Metod: Nisan 1996 ile 2003 Eylül tarihleri arasında, distal üreter taşı olan 840 hastaya üreterorenoskopi uyguladık. Retrospektif olarak dye laser ve pnömotik litotripsinin başarı oranlarını ve komplikasyonlarını değerlendirdik. Fragmentasyon sonrası stone-free olarak, taş çapını 4 mm veya altı olarak belirledik. Bununla birlikte, eğer taş çapı 4mm üzerinde ise forceps kullandık. Bulgular: Laser grubudaki 560 hastanın sadece 320'sinin (%57.14) taşları fragmante oldu (taş çapı4mm) stone free hasta sayısı 538'e (%96.07) yükseldi. Aynı şekilde pnömotik grupta 280 hastanın sadece 2017 (%71.78) taşları fragmente oldu ancak ek olarak forceps ve basket kullanıldığında stone free hasta sayısı 271"e (%96.78) yükseldi. Her iki grubunda komplikasyon oran-ları benzerdi ama taş migrasyonu pnömotik grupta yüksekti. Sonuç: Çalışmamızda, pnömotik grupta fragmentasyon ve stone-free oranlarının yüksek olmasına rağmen, total stone-free oranlarının her iki grupta benzer olduğunu saptadık.

Comparison of the results of pulsed dye laser lithotripsy and pneumatic lithotripsy for treatment of distal ureteral stones

Alm: To compare the succees rate and safety ofpulsed dye laser and pneumatic lithotripsy methods for distal ureteral stones. Materials and Methods: From April J 996 to September 2003, we performed üreteroscopy in 840 patients with distal ureteral stones. Retrospectively, we evaluated the success rate and complications of dye laser and pneumatic lithotripsy. After fragmentation was determined as stone size 4mm, we used forceps. Results: Only 320 of 560 patients (57,14%) were fragmented in laser group (stone size4mm) increased patients up to 538 (96,07%) as stone-free. The same way only 201 of 280 patients (71.78%) were frag-mented in pneumatic group and additional forceps use increased patients up to 271 (96,78%) as stone-free. in both group, complications ratio was similar but stone migration was higher in pneumatic group. Conclucions: in our study, we observed fragmantation and stone-free ratio higher in pneumatic group though total stone-free ratio were similar in both group.

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