Mehmet Oğuz ŞAHİN, Volkan ŞEN, Bora İRER, Güner YILDIZ

Distal Üreteral Taşların Üreterorenoskopik Tedavisinde Balon Dilatasyonunun Etkinlik Ve Güvenilirliğinin Değerlendirilmesi

Amaç: Distal üreteral taşların üreterorenoskopik tedavisinde balon dilatasyonunun etkinlik ve güvenilirliğini değerlendirilmeyi amaçladık.Gereç ve yöntemler: Distal üreter taşı nedeni ile Ocak 2007 – Haziran 2018 tarihleri arasında URS yapılan ardışık hastaların verileri retrospektif olarak değerlendirildi. Hastalar balon dilatasyon ihtiyacına göre 2 gruba ayrıldı. Grup 1 balon dilatasyon (-) hastalardan; Grup 2 ise balon dilatasyon (+) hastalardan oluşmaktaydı. Bu iki grup hastaların demografik özellikleri, taş karakteristikleri, operasyon sonuçları ve komplikasyonları açısından karşılaştırıldı.Bulgular: Grup 1’de 359 (%70.4) erkek, 151 (%29.6) kadın; grup 2’de ise 32 (%80.0) erkek ve 8 (%20.0) kadın hasta bulunmaktaydı (p=0.197). Grup 1 için yaş ortalaması 43.3±14.3 yıl iken, grup 2 için 44.2±14.9 yıl olarak hesaplandı ve gruplar arası fark yoktu (p=0.704). Ameliyat süresi balon dilatasyon grubunda daha uzun idi (grup 1’de 32.8±20.5 dk ve grup 2’de 40.1±16.0 dk; p=0.029). Postoperatif taşsızlık oranı grup 1’de anlamlı şekilde daha yüksek olmasına rağmen (%98.6 vs %90.0; p=0.017), komplikasyon oranları gruplar arasında benzer olarak saptandı (%3.2 vs %2.5; p=0.787). Sonuç: Distal üreter taşı tedavisi amaçlı yapılan üreterorenoskopide üreter darlıkları için eş zamanlı balon dilatasyonu uygulaması, güvenli ve maliyetleri azaltan bir yöntemdir. Operasyon süresinde bir miktar uzama ve taşsızlık oranlarındaki düşmeye rağmen, komplikasyon oranlarını etkilememektedir ve aynı taş için yeni operasyondan hastayı korumaktadır. Bu işlemin uzun dönem sonuçları için prospektif ve randomize çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler:

üreter balon dilatasyon, üreter taşı, üreter taş tedavisi, üreteroskopi

Evaluation Of Efficacy And Safety Of Balloon Dilatation İn Ureterorenoscopy For The Treatment Of Distal Ureteral Stones

Objective: We aimed to evaluate the efficacy and safety of balloon dilatation in ureterorenoscopy for the treatment of distal ureteral stones.Materials and Methods: The retrospective data of patients who underwent URS for distal ureter stones between January 2008 and June 2018 were evaluated. Patients were divided into two groups according the need of balloon dilatation. Group 1 was consisted of balloon dilatation (-) patients and Group 2 was cosnsited of balloon dilatation (+) patients. These two groups were compared in terms of demographic of patients, stone characteristics, operation outcomes and complications. Results: Group 1 was consisted of 359 (70.4%) male and 151 (29.6%) female; group 2 was consisted of 32 (80%) male and 8 (20%) female patients (p=0.197). The mean age of patients was 43.3±14.3 years in group 1 and 44.2±14.9 years in group 2 (p=0.704). Operation time was significantly higher in group 2 (32.8±20.5 min vs 40.1±16.0; p=0.029). Although stone free rate was significantly higher in group 1 (%98.6 vs %90.0; p=0.017); the complication rate was similar between groups (%3.2 vs %2.5; p=0.787).Conclusions: The same session balloon dilatation for ureteral structures in ureterorenoscopy for the treatment of distal ureteral stones seems safe and cost-effective method. Although this procedure may lead to elongation in operation times and decrease the stone free rates; it does not affect the complication rates and prevents patients from needing a new operation for same stone. Further randomized and prospective studies are needed for long term outcomes of this procedure.

Keywords:

ureteral balloon dilatation, ureteral stone, ureteral stone treatment, ureteroscopy,

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