Serkan YARIMOĞLU, Tansu DEĞİRMENCİ, Ufuk ÇAĞLAR, Murat ŞAHAN, Kağan Türker AKBABA, Murathan MURATOĞLU

BÖBREK TAŞLARI İÇİN PRİMER VE SEKONDER PROSEDÜR OLARAK PERKÜTAN NEFROLİTOTOMİ SONUÇLARININ KARŞILAŞTIRILMASI

Giriş: Biz bu çalışmada daha önce taş cerrahisi geçirmiş olmanın PNL sonuçları ve komplikasyonları üzerine etkisini değerlendirmeyi amaçladık. Gereç ve Yöntem: 2012-2017 yılları arasında Bozyaka Eğitim ve Araştırma Hastanesi Üroloji Kliniği’nde böbrek taşına yönelik PNL yapılan hastaların verileri retrospektif olarak incelendi. Daha önce böbrek taşı nedeniyle aynı taraf böbrekten taş cerrahisi öyküsü olmayan hastalar (primer PNL) grup-1 ve aynı taraf böbrek için PNL veya açık taş cerrahisi öyküsü olan hastalar (sekonder PNL) grup-2 olarak iki gruba ayrıldı. Hastaların demografik ve preoperatif özellikleri kaydedildi. Ayrıca intraoperatif ve postoperatif sonuçlar (ameliyat ve floroskopi süresi, hastane yatış süresi, komplikasyonlar ve taşsızlık durumu) incelendi. Bulgular: Çalışmaya katılan hastaların 535'i grup-1, 227’si ise grup-2’deydi. Grup 1’deki hastaların yaş ortalaması 47.9±13.1, grup 2’deki hastaların yaş ortalaması 47.7±12.8 idi (p=0.832).Taş boyutu grup 1’de 23.4±11.4 mm, grup 2’de 24.2±9.8 mm idi (p=0.476). Grup-1’ de operasyon süresi 99.9±37.3 dk, grup-2’de ise 109.4±45.3 dk idi (p=0.003). Taşsızlık durumunda iki grup arasında anlamlı derecede farklılık saptandı. Grup 1' de taşsızlık oranı %90.3, grup 2'de %79.3 olarak gözlendi (p=0.003). Her iki grupta komplikasyon görülme oranında anlamlı farklılık saptanmadı, grup-1’de %25.9, grup 2'de %30.3 olarak gözlendi (p=0.211) Sonuç: Sonuçlarımız PNL’nin daha önce taş cerrahisi geçirmiş hastalarda güvenli bir şekilde fakat daha uzun operasyon süresi ve daha düşük başarı oranı ile uygulanabilirliğini göstermiştir.

COMPARISON OF THE RESULTS OF PERCUTAN NEPHROLITOTOMY AS PRIMARY AND SECONDARY PROCEDURE FOR KIDNEY STONES

Introduction: In this study, we aimed to evaluate the effect of being had stone surgery’s PNL results and complications. Material and Method: The data of patients who underwent PNL for kidney stones in the Urology Clinic of Bozyaka Education and Research Hospital between 2012 and 2017 were analyzed retrospectively. Patients who have underwented open stone surgery (Secondary PNL) as group-2 and have not underwented open stone surgery yet (Primary PNL) as group-1 were divided into two groups. Demographic and postoperative characteristics of the patients were recorded. In addition, intraoperative and postoperative results (duration of surgery and fluoroscopy, duration of hospital stay, complications and stone-free status) were examined. Results: Of the patients participating in the study, number of 535 were in group-1 and 227 were in group-2. The mean age of the patients in group 1 was 47.9±13.1, and the mean age of the patients in group 2 was 47.7±12.8 (p=0.832). The stone size was 23.4±11.4 mm in group 1 and 24.2±9.8 mm in group 2 (p=0.832). =0.476). The operation time was 99.9±37.3 minutes in group-1 and 109.4±45.3 minutes in group-2 (p=0.003). There was a significant difference between the two groups in terms of stone-free status. Stone-free rate was 90.3% in group 1 and 79.3% in group 2 (p=0.003). There was no significant difference in the incidence of complications in both groups, 25.9% in group-1 and 30.3% in group 2 (p=0.211) Conclusion: Our results showed that PNL can be performed safely but with a longer operation time and lower success rate in patients who have undergone previous stone surgery.

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