Ismail BASMACI, Ibrahim Halil BOZKURT, Serdar CELİK, Ertugrul SEFİK, Anıl EKER, Bulent GUNLUSOY, Tansu DEĞİRMENCİ

EFFICACY OF PEROPERATIVE FLUOROSCOPY IMAGE IN DETECTION OF RESIDUAL FRAGMENTS AFTER PCNL OPERATION

Introduction: To compare the combination of peroperative fluoroscopy image and the first week ultrasonography with the firsth month Non-contrast computarised tomography (NCCT) for The Detection Of Residual Fragments after Percutaneous nephrolithotomy (PCNL) operation. Material and Method: A total of 208 Patients who underwent PCNL due to a radioopaque renal stone in between January 2018 to January 2019 in our clinic were included in this study. Techniques for the detection of residual fragments (RF) (fluoroscopy, plain radiography of the kidneys, ureters, and bladder (KUB), ultrasonography (US), NCCT and combination of US + fluoroscopy) were compared according to sensitivity, specificity, positive predictive value and negative predictive value Results: Sensitivity and specifisity rates of the prediction of postoperative fluoroscopy and postoperative 1st week US combination were 91.3% and 98.8% (PPV: 95.5% and NPV: 97.6%) for RF status; and 91.7% and 96.5% (PPV: 84.6% and NPV: 98.2%) for CSRF (>4mm) status, respectively. Conclusion: In this study, we showed that the combination of fluoroscopy and US has high sensitivity and specificity values for RF detection without x-ray exposure such as KUB and NCCT.

PCNL OPERASYONU SONRASI REZİDÜEL FRAGMANLARIN TESPİTİNDE PEROPERATİF FLOROSKOPİ GÖRÜNTÜSÜNÜN ETKİNLİĞİ

Giriş: Perkütan nefrolitotomi (PCNL) ameliyatı sonrası rezidüel fragmanların tespitinde peroperatif floroskopi görüntüsü ile ilk hafta ultrasonografi kombinasyonunu non kontrast bilgisayarlı tomografi (NKBT) ile karşılaştırmak. Gereç ve Yöntem: Kliniğimizde Ocak 2018 - Ocak 2019 tarihleri arasında radyopak böbrek taşı nedeniyle PCNL yapılan toplam 208 hasta çalışmaya alındı. Rezidüel fragmanların (RF) tespitinde kullanılan teknikler (floroskopi, direk üriner sistem grafisi (DÜSG)), ultrasonografi (US), NKBT ve US + floroskopi kombinasyonu) duyarlılık, özgüllük, pozitif ve negatif prediktif değerler açısından karşılaştırıldı. Bulgular: RF tespitinde peroperatif floroskopi görüntüsü ile ilk hafta ultrasonografi kombinasyonunun duyarlılık ve özgüllük oranları % 91.3 ve % 98.8 (PPV:% 95.5 ve NPV:% 97.6), klinik önemli rezidüel fragman tespitinde (>4mm) ise 91.7 ve% 96.5 (PPV:% 84.6 ve NPV:% 98.2) olarak bulunmuştur. Sonuç: Bu çalışmada, floroskopi ve US kombinasyonunun DÜSG ve NKBT gibi x-ray maruziyeti olmadan RF tespiti için yüksek hassasiyet ve özgüllük değerlerine sahip olduğunu gösterdik

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