Ümit YILDIRIM, Mehmet USLU, Mehmet EZER, Rasim GÜZEL, Kemal SARICA

Flexible URS sonrası uzun dönem taşsızlık oranları: DJ-stentin boyutu sonuçları etkiliyor mu?

Amaç: Bu çalışmada, kullanılan double- J (DJ) stent çapının, flexible üreteroskopik (fURS) böbrek taşı tedavisinin taşsızlık oranları ve postoperatif ağrı durumuna olası etkisini araştırdık. Gereç ve Yöntemler: Böbrek taşı nedeniyle fURS uygulanan toplam 104 hasta çalışmaya dahil edildi. Taş tedavisi sonrası 51 hastaya 4.7 Fr DJ stent takılırken, 53 hastaya 6 Fr stent takıldı. Postoperatif 3. ayda kontrastsız bilgisayarlı tomografi ile incelenen taşsızlık durumuna ek olarak, iki grubun genel ağrı semptomları, postoperatif ilk haftayı takiben uygulanan görsel ağrı skalası ile değerlendirildi. Başarı, taşların tamamen temizlenmesi veya küçük taş parçalarının (<3 mm) varlığı olarak belirlendi. Bulgular: İki grubun genel ağrı semptomları, görsel ağrı skalası kullanılarak ölçüldüğünde 6 Fr grubu daha öndeydi (4.02±1.10 vs 4.81±1.53, p=0.006). İki grup taşsızlık oranları açısından anlamlı fark göstermedi (%84.3 vs %74.5, p=0.264). İki grup arasında postoperatif ateş, stent migrasyonu veya acil servis ziyaretleri açısından istatistiksel olarak anlamlı bir fark bulunamadı. Sonuç: Bu çalışma, daha büyük çaplı stentlerin hastalarda daha yüksek ağrı şikayetlerine neden olmasına rağmen, uzun süreli taşsızlık oranlarını önemli ölçüde etkilemediğini belirledi. Flexible üreteroskopik cerrahi sonrası stent seçimi söz konusu olduğunda 6 Fr yerine 4.7 Fr DJ tercih edilmelidir.

Anahtar Kelimeler:

Dj stent çapı, böbrek taşları, flexible üreterorenoskopi, taşsızlık

Long-term stone-free rates after flexible URS: Does the size of DJ stent affect the outcomes

Objective: This study’s main goal was to evaluate the possible impact of different-sized double-J (DJ) stents on the pain and stone-free status following flexible ureteroscopic laser disintegration (fURS) of renal stones. Material and Methods: A total of 104 patients who underwent fURS for kidney stones were included in our study. In 51 patients, a 4.7 Fr DJ stent was used after stone fragmentation, while in the remaining 53 cases, a 6 Fr stent was chosen. Between the two groups, general pain symptoms were evaluated using a visual pain scale at the end of the first postoperative week. The stone-free status was evaluated using non-contrast computed tomography (NCCT) after three months following surgery. Success was determined by either the complete clearance of the stones or the presence of small stone fragments (<3 mm). Results: Using a visual pain scale, we compared the two groups’ overall reports of pain (4.02±1.10 vs 4.81±1.53, p=0.006). When we looked at the stone-free rates, the two groups were not significantly different in this regard (84.3% vs 74.5%, p=0.264). We found no statistically significant difference between the two groups in terms of postoperative fever, stent migration, or visits to the emergency room. Conclusion: In spite of the fact that larger diameter stents resulted in more pain complaints for patients, they did not alter the long-term stone-free rates appreciably, as evidenced by our findings. In order to reduce the occurrence of unpleasant symptoms, a 4.7 Fr double-j stent may be preferable over a 6 Fr stent following flexible ureteroscopic surgery.

Keywords:

Double-j stent diameter, renal stones, flexible ureterorenoscopy, stone free,

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