İki Santimetreden Küçük İzole Böbrek Pelvis Taşlarında Semirijid ve Fleksibl Üreteroskopi Sonuçlarının Karşılaştırması

Amaç: Çalışmamızda böbrek pelvisinde izole 2 cm’den küçük taşı olan hastaların tedavisinde semirijid ureteroskopi (S-URS) ve fleksibl üreteroskopi (F-URS) kulanımının etkinlik ve güvenilirliklerini karşılaştırmayı amaçladık.Materyal ve Metod: İki cm’den küçük izole böbrek pelvis taşı nedeniyle üreteroskopik taş tedavisi uygulanan toplam 45 hastanın verileri retrospektif olarak değerlendirildi. S-URS tüm hastalara rutin olarak uygulandı. S-URS ile taşlara böbrek pelvisinde erişilebiliyorsa doğrudan holmiyum lazer ile tedavi uygulandı. Taş erişilebilir değilse F-URS yapıldı. Gruplar taşsızlık oranları, operasyon süreleri, hemoglobin düşüşü ve komplikasyonlar bakımından karşılaştırıldı. Bulgular: 24 (%53,3) hastaya S-URS ve 21 (%46,7) hastaya F-URS yapıldı. İki grup arasında yaş, hidronefroz derecesi, ortalama taş boyutu ve taş tarafı bakımından anlamlı farklılık yoktu. Ortalama operasyon süresi S-URS grubunda 64,62±9,34 dakika, F-URS grubunda 96,43±14,26 dakika idi (p=0,001). Gruplar arasında postoperatif komplikasyonlar açısından istatistiksel olarak anlamlı fark yoktu (p=0,548). Postoperatif 1. gün ve 1. ay takipte taşsızlık oranları S-URS grubunda sırasıyla %79,2 ve %83,3 ve F-URS grubunda %80,9 ve %85,7 idi (p=0,768 ve p=0,574).Sonuç: İki cm'den küçük böbrek taşlarında S-URS ve F-URS kullanımının oldukça başarılı ve güvenli yöntemler olduğunu gözlemledik. S-URS özellikle seçilmiş olgularda böbrek pelvisinde taşa sorunsuz bir şekilde ulaşılabiliyorsa uygulanabilecek güvenli bir tedavi yöntemidir.

Anahtar Kelimeler:

Böbrek taşı, Semirijid, Fleksibl, Üreteroskopi

Comparison of Semirigid and Flexible Ureteroscopy Results in Isolated Kidney Pelvis Stones Smaller than Two Centimeters

Background: In our study, we aimed to compare the efficiency and reliability of using semirigid ureteroscopy (S-URS) and flexible ureteroscopy (F-URS) in the treatment of patients with stones smaller than 2 cm in isolated renal pelvis.Materials and Methods: The data of 45 patients who underwent ureteroscopic stone treatment for isolated renal pelvis stones smaller than 2 cm were evaluated retrospectively. S-URS was routinely applied to all patients. If the stones can be accessed in the renal pelvis with S-URS, direct treatment with holmium laser was applied. If the stone was not accessible, F-URS was made. Groups were compared in terms of stone-free rates, operation times, hemoglobin reduction, and complications.Results: S-URS was performed in 24 (53.3%) patients and F-URS in 21 (46.7%) patients. There was no significant difference between the two groups in terms of age, degree of hydronephrosis, mean stone size and stone side. Mean operation time was 64.62 ± 9.34 minutes in the S-URS group and 96.43 ± 14.26 minutes in the F-URS group (p=0.001). There was no statistically significant difference between the groups in terms of postoperative complications (p = 0.548). In the postoperative 1st day and 1st month follow-up, stone-free rates were 79.2% and 83.3% in the S-URS group, and 80.9% and 85.7% in the F-URS group, respectively (p = 0.768 and p = 0.574).Conclusions: We observed that the use of S-URS and F-URS were very successful and safe methods in kidney stones smaller than 2 cm. S-URS is a safe treatment method that can be applied if the stone in the renal pelvis can be reached without any problem, especially in selected cases.

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