Perkütan Nefrolitotomi Ameliyatları Öncesinde Retrorenal Kolon Saptanması İatrojenik Kolon Yaralanması Olasılığını Azaltmaz

GİRİŞ ve AMAÇ: Avrupa Üroloji kılavuzuna göre; büyük, multiple yada alt pol kaliksi yerleşimli böbrek taşlarında birinci basamak tedavi yöntemi perkütan nefrolitotomidir (PNL). Kolon yaralanması; PNL’nin nadir görülen ancak ciddi bir komplikasyonudur. Retrorenal kolon varlığını PNL sonrası kolon yaralanması için risk faktörü olarak bildiren çalışmalar mevcuttur. Bu çalışmada; preoperatif radyolojik incelemede retrorenal kolon saptanan ve PNL sonrası kolon yaralanması olan olgular retrospektif olarak değerlendirilmiştir. YÖNTEM ve GEREÇLER: Ocak 2015- Aralık 2017 tarihleri arasında böbrek taşı tanısı ile perkütan nefrolitotomi yapılan hastaların kayıtları geriye yönelik incelendi. PNL öncesi böbrek anatomisi, taş ya da taşların yapısı ve retrorenal kolon araştırılması için hastalara supin pozisyonda taş protokollü tomografi görüntülemeleri yapıldı. BULGULAR: Yaş, cinsiyet, geçirilmiş abdominal cerrahi öyküsü, taşın bulunduğu taraf, VKİ verilerinin değerlendirilmesi sonucunda; yaş ve düşük VKİ retrorenal kolon için risk faktörü olarak saptandı (tablo 1). Retrorenal kolon varlığının da kolon yaralanması için istatistiksel anlamlı risk faktörü olduğu saptandı (p

Retrorenal Colon Detection Before Percutaneous Nephrolithotomy Surgery Does Not Reduce the Probability of Iatrogenic Colon Injury

INTRODUCTION: Percutaneous nephrolithotomy (PNL) is the first line of treatment for renal stones with large, multiple or lower pole calix. Colon injury; is a rare but serious complication of PNL. Early diagnosis and appropriate treatment are vital in colon injury. Presence of retorenal colon as a risk factor for colon injury after PNL. In this study; Preoperative radiological examination revealed retrorenal colon and colon injury after PNL were evaluated retrospectively. METHODS: The records of patients who underwent percutaneous nephrolithotomy with the diagnosis of kidney stones were retrospectively reviewed. Renal anatomy, the structure of the stones or stones and the retrorenal colon were examined by supine position noncontrast tomography. RESULTS: As a result of the evaluation of age, sex, previous abdominal surgery history, side of stone, BMI data; age and low BMI were determined as risk factors for retrorenal colon (table 1). Retrorenal colon was also found to be a statistically significant risk factor for colon injury (p

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