Distal Üreteral Taşların Üreterorenoskopik Tedavisinde Balon Dilatasyonunun Etkinlik Ve Güvenilirliğinin Değerlendirilmesi

Amaç: Distal üreter taşlarının üreteroskopik (URS) tedavisinde balon dilatasyonun 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 dila-tasyon uygulanmayan (-) hastalardan; Grup 2 ise balon dilatasyon uygulanan (+) hastalardan oluş-maktaydı. Bu iki grup demografik özellikleri, taş karakteristikleri, operasyon sonuçları ve kompli-kasyonları 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 şe-kilde daha yüksek saptanırken (%98.6 vs %90.0; p=0.017), komplikasyon oranları gruplar arasında benzerdi (%3.2 vs %2.5; p=0.787). Sonuç: Distal üreter taşı tedavisi amaçlı yapı-lan URS’de üreter darlıkları için eş zamanlı ba-lon dilatasyon uygulaması, güvenli ve maliyetleri azaltan bir yöntemdir. Operasyon süresinde bir miktar uzama ve taşsızlık oranlarındaki azalmaya rağmen, komplikasyon oranlarını etkilememek-tedir ve aynı taş için yeni operasyondan hastayı korumaktadır. Bu işlemin uzun dönem sonuçları için prospektif ve randomize çalışmalara ihtiyaç duyulmaktadır.

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 ureteroscopy (URS) for the treatment of distal ureteral stones. Material 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 consisted 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 URS 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.

Kaynakça

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Kaynak Göster

Yeni Üroloji Dergisi
  • ISSN: 1305-2489
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2005

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