M. Serdar BUĞDAY, EYÜP VELİ KÜÇÜK, Uğur BOYLU

Aynı klinikte yapılan 200 perkütan nefrolitotomi operasyonunu uygulayan daha önce perkütan eğitimi almış ve almamış iki farklı cerrahın iki dönem sonuçlarının değerlendirilmesi

Amaç: Kliniğimizde 200 perkütan nefrolitotomi PNL olgusu, daha önce PNL için çeşitli eğitim kursları alan ve öğrenme eğrisini başka bir klinikte tamamlayan tecrübeli bir cerrah ile ilk defa farklı bir tecrübeli cerrah gözetiminde PNL yapmaya başlayan diğer bir cerrah tarafından uygulanmıştır.Amacımız bu 200 olguyu iki dönem halinde incelemek ve her iki cerrah için preoperatif, operatif ve postoperatif hasta verilerini ve başarı oranlarını bu dönemler içerisinde karşılaştırmaktır. Yöntem ve Gereçler: Kliniğimizde Ağustos 2010 ile Temmuz 2012 yılları arasında uygulanan 200 PNL operasyonu iki dönem halinde incelenerek tecrübeli ve tecrübesiz cerrah by experienced or inexperienced surgeons. All tarafından yapılan operasyonlar olmak üzere facts’ preoperative and demogrophic datas were iki gruba ayrıldı. Tüm olguların preoperatif verileri ve demografik verileri değerlendirmeye case of the size of the stone, stone localization, alındı. Olgular ayrıca taş boyutu, taş lokalizasthe duration of the operation, fluoroscopy, proyonu, operasyon süresi, skopi süresi, nefrostomi alınma süresi, preoperatif hemoglobin ve tive hemoglobin and hematocrit, postoperative hematokrit oranları, postoperatif hemoglobin hemoglobin and hematocrit, the rates of compve hematokrit oranları, komplikasyon oranları, transfüzyon oranları ve taşsızlık oranları bakımından karşılaştırıldı. Bulgular: İlk dönemde tecrübeli cerrahın operasyon süresi 2,21 saat, tecrübesiz cerrahın operasyon süresi 2,76 saat olarak bulundu. Yine skopi süreleri tecrübeli cerrah için 2,81 dakika olarak hesaplanırken, tecrübesiz cerrahta bu rostomy tube. W ere calculated as 2.75 days for süre 4,05 dakika olarak hesaplandı. Nefrostomi alında süreleri tecrübeli cerrah için 2,75 gün, tecrübesiz cerrah için 3,84 gün olarak hesaplandı. Tecrübeli grupta sadece 4 hastaya transfüzyon uygulanırken, tecrübesiz grupta 14 hastaya transfüzyon uygulandı. İlk dönem için her iki cerrah arasında operasyon süreleri, skopi süreleri ve nefrostomi alınma süreleri, transfüzyon oranları arasında istatistiksel olarak anlamlı fark saptandı p

Anahtar Kelimeler:

perkütan nefrolitotomi, böbrek taşı, komplikasyon

The evaluation of 200 pnl procedure results which was made by an experienced and inexperienced surgeons in two different periods at the same clinic

Objective: In our clinic, 200 percutaneous nephrolithotomy PNL cases were perfomed by an experienced surgeon who was completed his training and learning curve in another centre and an unexperienced surgeon who was starting PNL under an experienced surgeon’s supervision. Our aim is to examine these 200 cases in two periods, and to compare the preoperative, operative and postoperative patient’s data and success ratios for both of surgeons within this period. Material and Methods: In our clinic; the 200 PNL operations, which were performed between August 2010 and July 2012, were examined and seperated into two groups as performed by experienced or inexperienced surgeons. All facts’ preoperative and demogrophic datas were evaluated. Besides; the facts were compared in case of the size of the stone, stone localization, the duration of the operation, fluoroscopy, process of nephroscopy taken, the rates of preoperative hemoglobin and hematocrit, postoperative hemoglobin and hematocrit, the rates of complication, transfusion rates and being stone-free. Findings: The experienced surgeon’s operation time was 2.21 hours and inexperienced surgeon’s was 2.76 hours. Again; scopy periods/ durations were calculated as 2.81 minutes for the experienced and 4.05 minutes for inexperienced surgeon. The duration of removal of nephrostomy tube. W ere calculated as 2.75 days for the experienced and 3.84 days for the inexperienced surgeon. In the experienced group, only 4 transfusions were made, yet in inexperienced group, this number reached 14. For the first period; a meaningful difference was determined statistically between both the surgeons in the duration of operation, scopies and removing nefrostomy and transfusion rates p

Keywords:

percutaneous nephrolithotomy, kidney stone, complication,

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