Ömer Faruk Bozkurt, Ali Ünsal, Çağrı Şenocak, Erkan Sadioğlu, Rıdvan Özbek, Selçuk Sarıkaya

Böbrek Taşı Olan Çocuklarda Önceki Taş Tedavisinin Perkütan Nefrolitotomi Sonuçlarına Etkisi

Amaç: Biz bu tek merkezli çalışmada, daha önce aynı taraf şok dalga litotripsi (SWL), perkütan nefro- litotomi (PNL) veya açık böbrek taş cerrahisi olan ve olmayan çocuk hastalarda uyguladığımız PNL ope - rasyonlarının perioperatif sonuçlarını karşılaştırmayı amaçladık. Gereç ve Yöntemler: 2008–2016 tarihleri arasın- da kliniğimizde PNL operasyonu uygulanmış 18 yaş altı çocukların verileri retrospektif olarak değerlen - dirildi. Olgular, böbrek taşı tanısı ile daha önce aynı taraf SWL, PNL veya açık cerrahiyi içeren taş tedavisi öyküsü olanlar (grup 1) ve olmayanlar (grup 2) olarak iki gruba ayrıldı. Demografik veriler ile preoperatif ve operatif veriler belirlenen gruplar arasında karşı - laştırıldı. Postoperatif 6. haftada çekilen direkt üriner sistem grafisinde (radyolüsent taşlarda kontrastsız bilgisayarlı tomografide) 4 mm ve üzeri taşlar rezidüel taş olarak kabul edildi. Postoperatif komplikasyonlar modifiye Clavien sınıflamasına göre kaydedildi. PNL sonrası rezidüel taş varlığı ve komplikasyonlar iki grup arasında karşılaştırıldı. Bulgular: Çalışmaya alınan toplamda 122 çocuk PNL olgusunun ortalama yaşı (mean±SD) 7.14±4.86 olarak saptandı. 122 PNL olgusunun 35’inde (%28.69) aynı taraf böbrek taşına yönelik tedavi öyküsü vardı. Hemoglobin değerlerinde değişim (p=0.997), ope - rasyon (p=0.584) ve hastanede kalış (p=0.997) süresi açısından iki grup arasında istatistiksel olarak anlamlı fark yoktu. Gruplar arasında karşılaştırılan rezidüel taş (p=0.365) ve postoperatif komplikasyon (p=0.886) oranları arasında da istatiksel anlamlı fark saptanmadı. Sonuç: Bu çalışmanın sonuçları, PNL’nin böbrek taşı tedavisi geçirmiş çocuk hastalarda güvenli bir şe - kilde uygulanabileceğini ortaya koymaktadır.

Impact of Previous Stone Treatment on the Outcomes of Percutaneous Nephrolithotomy in Children with Renal Stones

Objective: In this single center study, we aimed to compare perioperative outcomes of PCNL in pediat - ric patients with and without history of previous stone treatments including open renal stone surgery, PCNL, and shockwave lithotripsy (SWL). Material and Methods: We retrospectively evalu- ated children under 18 years of age who underwent PCNL operation between 2008 and 2016 in our clinic. Cases were further divided into two groups: patients with a history of open renal surgery or PCNL or failed SWL on the same side were categorized as group 1, primary PCNL patients were categorized as group 2. Demographic data, preoperative and operative data were compared between the selected two groups. We used kidney-ureter-bladder radiography (non-con - trast-enhanced computed tomography in cases with non-opaque stones) that performed 6 weeks postop- eratively for the assessment of residual stones (≥4mm). Postoperative complications were recorded according to modified Clavien classification. Residual stone rates and complications of PCNL were compared between the two groups. Results: The study included 122 PCNL cases with mean±SD age of 7.14±4.86 years. 35 of the 122 PNL cases (28.69%) had a history of previous stone treat - ment for the same side kidney stone. There was no sta- tistically significant difference between the two groups in terms of change in hemoglobin values (p=0.997), operation time (p=0.584) and hospital stay (p=0.997). No statistically significant difference was found the residual stone rates (p=0.365) and postoperative com- plications (p=0.886), as well. No statistically significant differences were found between the groups for the rates of residual stones (p=0.365) and postoperative complications (p=0.886), as well. Conclusion: The results of this study demonstrate that PCNL can be safely performed in children with previous stone treatment

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