Mehmet CANİKLİOĞLU, Ünal ÖZTEKİN, Sercan SARI, Volkan SELMİ, Abdullah GÜREL, Levent IŞIKAY, Fatih ATAÇ

Preoperatif Stent Uygulamasının Retrograd İntrarenal Cerrahi Sonuçları Üzerine Etkisi

Amaç: Retrograd intrarenal cerrahi genellikle 10-20 mm boyutunda üreteral ve renal taşların tedavisinde endikedir. Bazen primer retrograd endoskopi mümkün olmayabilir. Bu durumlarda prestent uygulaması üreteroskop veya üreteral akses kılıfın geçişini kolaylaştırabilir. Bu çalışmada, preoperatif üreter stent uygulamasının, retrograd endoskopik taş cerrahisi sonuçları üzerine etkisi değerlendirilmiştir. Gereç ve Yöntemler: Ocak 2015-Ekim 2018 tarihleri arasında proksimal üreter veya intrarenal taşı olan hastalarda uygulanan retrograd intrarenal cerrahi sonuçları analiz adildi. Ameliyat öncesi 67 hastada üreteral stent vardı (Grup 1). Veri tabanında benzer özellikleri olan 67 hasta seçilerek kontrol grubu (Grup 2) oluşturuldu. İki grubun preoperatif, intraoperatif ve postoperatif verileri karşılaştırıldı. Bulgular: Geçirilmiş taş cerrahisi dışında iki grup arasında demografik ve preoperatif veriler arasında istatistiksel olarak anlamlı fark yoktu. Genel komplikasyon taşsızlık, ameliyat süresi ve postoperatif çift J yerleştirme oranı iki grup arasında benzerdi. Her iki grupta çoğunlukla minör komplikasyonlar görüldü. Grup 2'de iki hastada üreteral darlık görüldü. Sonuç: Retrograd intrarenal taş cerrahisi için preoperatif stent uygulamasının, cerrahi sonuçlar üzerine etkisi görülmemektedir.

IMPACT OF PREOPERATIVE STENT ON RETROGRADE INTRARENAL SURGERY OUTCOMES

Objective: Retrograde intrarenal surgery is commonly indicated for the treatment of 10-20 mm ureteral and renal stones. Sometimes, primary retrograde endoscopy is not possible. Pre-stenting may facilitate passage of ureteroscope or ureteral access sheath in these cases. This study aimed to assess the impact of preoperative ureteral stenting on the outcomes of retrograde endoscopic stone surgery. Material and Methods: A database of patients who underwent retrograde intrarenal surgery for proximal ureteral or renal calculi between January 2015 and October 2018 was analyzed. Sixty-seven patients had a ureteral stent preoperatively (Group 1). Control group (Group 2) consisting of 67 patients were chosen among the rest of the database with similar characteristics. Preoperative, intraoperative and postoperative data of two groups were compared.Results: There were no statistically significant differences in demographic and preoperative features between the two groups except for previous stone surgery. Overall complication rate, stone free rate, operation time and postoperative double J placement rate were similar between two groups. Most of the complications were low grade for both groups. In group 2 ureteral stricture was seen in two patients. Conclusion: Retrograde intrarenal surgery, Preoperative stent, Stone, Stone free rate, Double J stent.

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