Fatih GÖKALP, Halil İbrahim BOZKURT, Salih POLAT, Dursun BABA, Ömer KORAŞ, Murat ŞAHAN, Özgür DEYİRMENCİ

ANOMALİ BÖBREKLERDE FLEKSİBLE ÜRETEROSKOPİ (f-URS) DENEYİMLERİMİZ

Giriş: Anomalili böbreklerde böbrek ve proksimal üreter taşı hastaları için uyguladığımız fleksibl-URS ( f-URS) başarısını, komplikasyonlarını ve postopertif sonuçları sunmayı amaçladık. Gereç ve Yöntem: Nisan 2010 ile Haziran 2020 y ılları arasında anomali böbreği olan f-URS uygulanan 69 hastanın dosyaları retrospektif olarak tarandı. Hastalar ın dermografik özellikleri, operasyon süresi,skopi süresi, taşsızlık oranları, komplikasyon oranları kaydedildi. Final taşsızlık (FSFR); postoperastif birinci ayda yapılan ultrasonografi ve radiografik de ğerlendirilerek ta şın yoklu ğu veya bilgisayarlı tomografide 2mm den büyük ta ş fragmanı görülmemesi olarak tanımlandı. Bulgular: Toplam 69 hastanın; parsiyel nefrektomili üç, bifid pelvisli dört, atnalı böbrekli 14, ektopik böbrekli 15, rotasyon anomalilisekiz, duplike üreterli 12 ve kaliksiyel divertikül 13 hastaya f-URS yapıldı. Ortalama taş boyutu 15.1±7.7 mm 2 ve ortalama taş dansitesi (HU) 983±242 olarak saptandı. Tek seansta hastaların %78.2’sinde taşsızlık sağlanmışken ek gişim ile final taşszılık%85,5 olarak saptandı. Sonuç: Anormal böbrekli hastalarda f-URS teknik olarak zorlayıcı olabilse de endoürolojik tekniklerdeki ilerlemeler onu güvenli ve etkili bir prosedür haline getirmiştir. f-URS; daha az invaziv yap ısıve kabul edilebilir komplikasyon oranları nedeniyle anormal böbreklerdeki çoğu taş için çok etkili bir tedavi yöntemidir.

OUR EXPERIENCES OF FLEXIBLE URETEROSCOPY (f-URS) IN ANOMALY KIDNEYS

Introduction: We aimed to present the success, complications and postoperative results of flexible URS (f-URS) for patients with kidney and proximal ureteral stones in patients with anomalie kidney. Material and Method: A total of 69 patients with anomaly kidney who underwent f-URS between April 2010 and June 2020 were reviewed retrospectively. The patients' dermographic characteristics, operation time, fluoroscopy time, stone-free rates, and complication rates were re corded. Final Stone free (FSFR); It was defined as the absence of Stone by ultrasonography and radiographic evaluation performed in the postoperative first month or the absence of Stone fragments larger than 2mm in computed tomography. Results: A total of 69 patients; f-URS was performed in three patients with partial nephrectomy, four patients with bifid pelvis, 14 patients with horseshoe kidneys, 15 patients with ectopic kidn eys, eight patients with rotational anomaly, 12 patients with duplicated ureters and 13 patients with calyxal diverticulum. The mean stone size was 15.1±7.7 mm2 and the mean Stone density (HU) was 983±242. While stone-free was achieved in 78.2% of the patients in a single session, the final stone-free rate was found to be 85.5% with additional surgery. Conclusion: Although f-URS may be technically challenging in patients with abnormal kidneys, advances in endourological techniques have made it a safe and effective procedure. f-URS is a ve ry effective treatment for most stones in abnormal kidneys due to its less invasive nature and acceptable complicationrates.

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