Fatih SANDIKÇI, Burhan BAYLAN, Abdurrahim İMAMOĞLU

Endoskopik Taş Tedavisinde Gelecekte Bizleri Ne Bekliyor?

Son yıllarda; yaşlı popülasyonun artışı, artan obezite oranı, kötü beslenme alışkanlıkları, yetersiz sıvı alımı, sedanter yaşam tarzı gibi nedenler üriner sistem taş hastalığı insidansını da artırmaktadır (1). Artan insidans karşısında taş cerrahisi de operasyon teknikleri ve teknolojik ilerlemeler eşliğinde gelişimini sürdürmektedir. Son 30 yıldaki teknolojik gelişmeler, üriner sistem taş hastalığının tedavisinde devrim oluşturmuştur.Geçmişte, üriner sistem taş hastalıkları açık cerrahi yöntem ile tedavi edilirken, 1980’lerde ekstrakorporeal şok dalga litotripsi (ESWL) popülarize olmuş, sonraki yıllarda Perkütan Nefrolitotripsi tedavileriı gündemde yerini almıştır. Fleksibl üreteroskopinin (URS) kullanımı ve laser teknolojisindeki ilerlemeler sayesinde retrograd böbrek içi cerrahinin (RIRS) uygulanma sıklığı artmıştır. Avrupa Üroloji Kılavuzu’na baktığımızda 2 cm ve üzeri böbrek taşlarının tedavisinde perkütan nefrolitotomi (PNL) tercih edilmektedir. İki cm altındaki taşlarda ise taşın yerine ve kaliks yapısına tedaviye karar verilmektedir. Hasta pozisyonu, giriş teknikleri, mini perkütan yöntemleri, PNL-RIRS kombinasyonu, taşın 3 boyutlu demostrasyonu gibi alt başlıklardaki gelişmeler, gelecekte bizleri bu konuda nelerin beklediğini bugünlerden tahmin etmemizi sağlayabilir. Bu derlemede, endoskopik tedavi yöntemleriyle taş hastalığının güncel tedavileri, bu tedavi yöntemlerinin geleceği ve teknolojik yeniliklerin anlatılması amaçlanmıştır.

Anahtar Kelimeler:

endoskopik, endoüroloji, gelecek, laser, taş, yenilikler

What does expect us in endoscopic stone treatment in the future?

In recent years; reasons such as increased elderly population, increased obesity rate, poor eating habits, inadequate fluid intake, sedentary lifestyle also increases the incidence of urinary stone disease. In the face of increasing incidence, stone surgery continues its development, accompanied by operational techniques and technological advances. Technological advances in the last 30 years have revolutionized the treatment of urinary system stone disease. In the past, urinary stone diseases were treated with open surgery; in the 1980s, extracorporeal shock wave lithotripsy (SWL) became popular; in the following years, Percutaneous Nephrolithotomy (PNL) treatments have been on the agenda. With the use of flexible ureteroscopy (URS) and advances in lazer technology, the frequency of retrograde renal surgery (RIRS) has increased. According to the European Urology Guide; PNL is preferred for the treatment of renal stones of 2 cm or more. For stones smaller than 2 cm, treatment is decided according to the location of the stone and the calyceal structure. Advances in subheadings such as patient position, entry techniques, mini-percutaneous methods, PNL-RIRS combination and 3D demonstrations; It may provide us to predict what will be expected of us in the future from now. In this review; it is aimed to explain current treatment of stone disease with endoscopic treatment methods, the future of these treatment methods and technological innovations.

Keywords:

endoscopic, endourology, future, lazer, stone, innovations,

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