Ayhan KARAKÖSE, Mehmet Bilgehan YÜKSEL, Murat ÇİLOĞLU, Muammer ALTOK

Muş Devlet Hastanesi üroloji kliniğinde üst üriner sistem taşı cerrahi girişimlerinin analizi

Amaç: Bu çalışmada Muş Devlet Hastanesi üroloji kliniğinin üst üriner sistem taşlarına uyguladığı cerrahi girişimler incelenmiştir. Gereç ve Yöntem: Muş Devlet Hastanesi üroloji kliniğinde Şubat 2008 ile Şubat 2011 yılları arasında üst üriner sistem taşları için cerrahi girişim uygulanan 1108 hasta retrospektif olarak incelendi. ESWL tedavisine sevk edilen hastalar çalışma dışında bırakıldı. Bulgular: Kliniğimizde taş cerrahisi uygulanan 1108 hastanın yaş ortalaması 43,7 (19-72) dir. Bu hastaların 472si (%42,6) kadın, 636sı (%57,4) erkektir. Toplam 1071 (%96,7) hastaya endoskopik cerrahi [962 (%89,8) hastaya URS, 109 (%10,2) hastaya PCNL] , 37 (%3,3) hastaya ise açık cerrahi [11 (%29,7) hastaya üreterolitotomi, 24 (%64,9) hastaya piyelolitotomi, 2 (%5,4) hastaya nefrolitotomi] uygulanmıştır. Sonuç: Kliniğimiz üst üriner sistem taşlarında öncelikli olarak endoskopik cerrahiyi (üreter taşlarında URS, böbrek taşlarında PCNL) tercih etmektedir. Açık cerrahi kliniğimizde sadece seçilmiş nadir vakalarda tercih edilmektedir.

The analysis of surgical Treatment modalities applied for upper urinary tract stone diseases in the state Hospital of Mus, urology clinic

Objective: In this study, the surgical approaches that were applied for the upper urinary tract stones in The State Hospital of Mus Urology Clinic, were investigated. Materials and Methods: 1108 patients who underwent surgery for upper urinary tract stones in The State Hospital of Mus Urology Clinic between February 2008 and February 2011 were retrospectively reviewed. Patients who were referred to ESWL treatment were excluded from the study. Results: The mean age was 43.7 ( 19-72 ) years. 472 patients (42.6%) were women and 636 of the sample (57.4%) were male. Endoscopic surgery was applied to 1071 (96.7%) patients [URS was performed to 962 (89.8%) patients, PCNL was performed to 109 (10.2%) patients,], and open surgery was performed to 37 (3.3%) patients [ureterolithotomy was performed to 11 (29,7%) patients, pyelolithotomy was performed to 24 (64.9%) patients and nephrolithotomy was performed to 2 (5.4%) patients]. Conclusion: In our clinic endoscopic surgery (URS for ureteral stones, PCNL for kidney stones) is preferred as the primary treatment modality for the treatment of upper urinary tract stone disease. Open surgery is rarely preferred only in selected cases.

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1. Trinchieri A. Epidemiology of urolithiasis. Arch It Urol 1996; 68: 203-49.
2. Hesse A, Siener R. Current aspects of epidemiology and nutrition in urinary stones. World J Urol 1997; 15: 165-71.
3. Hollingsworth JM, Rogers MA, Kaufman SR at al. Medical therapy to facilitate urinary stone passage: A meta-analysis. Lancet 2006; 368: 1171-9.
4. Kim HH, Jo MK, Kwak C, Park SK. Prevalence and epidemiologic characteristics of urolithiasis in Seoul, Korea. Urology 2002; 59: 517-21.
5. Akıncı M, Esen T, Tellaloğlu S. Urinary stone disease in Turkey: an updated epidemiological study. Eur Urol 1991; 20: 200-3.
6. Muslumanoglu AY, Binbay M, Yuruk E at al. Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urol Res 2011; 39: 309-14.
7. Albala DM, Assimos DG, Clayman RV et al. Lower pole I: A prospective randomized trial of extracorporeal shockwave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasisinitial results. J Urol 2001; 166: 2072-80.
8. Peschel R, Janetschek G, Bartsch G. Extracorporeal shock wave lithotripsy versus ureteroscopy for distal ureteral calculi: A prospective randomized study. J Urol 1999; 162: 1909.
9. Hendrikx AJ, Strijbos WE, de Knijff DW et al. Treatment for estended-mid and distal ureteral stones; SWL or ureteroscopy? Results of a multicenter study. J. Endourol 1999; 13: 727-33.
10. Biri H, Küpeli B, Isen K, Sinik Z, Karaoğlan U, Bozkirli I. Treatment of lower ureteral stones: extracorporeal shockwave lithotripsy or intracorporeal lithotripsy? J Endourol 1999; 13: 77-81.
11. Küpeli B, Biri H, Isen K at al. Treatment of ureteral stones: comparasion of extracorporeal shock wave lithotripsy and endourologic alternatives. Eur Urol 1998; 34: 474-9.
12. Matlaga BR. Contemporary surgical management of upper urinary tract calculi. J Urol 2009; 181: 2152-6.
13. Güner ND, Alp T, Aydın A, Demir M, Aydın S. Treatment modalities for the upper urinary system stone disease in Turkey. Turkish J Urology 2010; 36: 369-74.
14. Türk C, Knoll T, Petrik A et al. Guidelines on Urolithiasis. European Association of Urology 2010.
15. Preminger GM, Tiselius HG, Assimos DG et al. American Urological Association Education and Research, Inc; European Association of Urology. 2007 Guideline for the management of ureteral calculi. Eur Urol 2007; 52: 1610-31.
16. Lotan Y, Gettman MT, Roehrborn CG, Cadeddu JA, Pearle MS. Management of ureteral calculi: a cost comparison and decision making analysis. J Urol 2002; 167: 1621-9.
17. Yencilek F, Sarıca K, Gürpınar T, Göktaş C, Cangüven Ö, Albayrak S. A comparison of shock wave lithotripsy, semirigid and flexible ureteroscopy in the management of proximal ureteral calculi.Türk Üroloji Dergisi 2009; 35: 101-7.
18. Kara C, Bayındır M, Çiçekbilek İ, Oğuz U, Ünsal A. Üreter alt uç taşlarının tedavisinde üreteroskopi ile vücut dışı şok dalga litotripsinin karşılaştırılması. Türk Üroloji Dergisi 2009; 35: 28-33.
19. Puppo P, Ricciotti G, Bozzo W, Introini C. Primary endoscopic treatment of ureteric calculi. A review of 378 cases. Eur Urol 1999; 36: 48-52.
20. Gunlusoy B, Degirmenci T, Arslan M et al. Ureteroscopic pneumatic lithotripsy: is the location of the stone important in decision making? Analysis of 1296 patients. J Endourol 2008; 22: 291-4.
21. Wolf JS, Clayman RV: Percutaneous nephrostolithotomy. What is its role in 1997? Urol Clin North Am 1997; 24: 43-58.
22. Kim SC, Kuo RL, Lingeman JE. Percutaneous nephrolithotomy: an update. J Urol 2005; 173: 1199.
23. Yalçın V, Önder U, Demirkesen O, Önal B, Kalkan M, Kural AR. Böbrek taşlarının tedavisinde perkütan nefrolitotomi. Türk Üroloji Dergisi 2002; 28: 194-200.
24. Ünsal A, Çimentepe E, Sağlam R. İlk 50 perkütan nefrolitotomi deneyimimiz. Türk Üroloji Dergisi 2002; 28: 422-7.
25. Segura JW, Preminger GM, Assimos DG et al. Nephrolithiazis clinical guidelines panel summary report on the management of staghorn calculi. J Urol 1994; 151: 1648-51.