İlkan GEÇİT, Necip PRİNÇÇİ, Mustafa GÜNEŞ, Serhat TANIK, KEREM TAKEN, Recep ERYILMAZ, Kadir CEYLAN

Laparoskopik basit nefrektomi: İlk deneyimlerimiz

Amaç: Kliniğimizde yapılan ilk laparoskopik basit nefrektomi vakalarını retrospektif olarak incelemek.Gereç ve Yöntem: Haziran 2010- Temmuz 2011 yılları arasında, toplam 12 hastaya transperitoneal laparoskopik basit nefrektomi yapıldı. Operasyon zamanı, kan kaybı, hastanede kalış ve takip süreleri, peroperatif ve postoperatif komplikasyonlar açısından incelendi.Bulgular: Hastaların 5’i %41.7 kadın, 7’si %58.3 erkek idi. Yaşları 12 ile 72 arasında ortalama 48 yaş idi. Dört %33.3 hastada sağ, 8 %66.6 hastada sol renal hastalık mevcuttu. Dört %33.3 hastada atrofik böbrek, 6 %50 hastada taşa sekonder nonfoksiyone hidronefrotik böbrek, 1 %8.3 hastada multikistik displastik böbrek, 1 %8.3 hastada ise vezikoüreteral reflüye bağlı nonfonksiyone böbrek mevcuttu. Ameliyat sırasında hiçbir hastaya kan transfüzyonu yapılmadı, ancak bir hastada kontrol edilemeyen kanama sebebiyle açık cerrahiye geçildi. Postoperatif herhangi bir komplikasyon gözlenmedi. Ameliyat süresi ortalama 100dk 80–160 dk idi. Hastaların hastanede kalış süreleri ise ortalama 3.2gün 2–6 gün idi. Ortalama takip süresi 6.8 ay idi.Sonuç: Laparoskopik nefrektomi hastalar tarafında daha iyi tolere edilmesi, daha az hastanede kalış süresi, daha az postoperatif ağrı kesici ihtiyacı ve daha iyi kozmetik sonuçları ile tercih edilir bir tedavi yöntemidir

Anahtar Kelimeler:

Laparoskopi, transperitoneal, nefrektomi

Laparoscopic simple nephrectomy: Our ınitial experiences

Objective: To retrospectively examine the initial cases undergoing laparoscopic simple nephrectomy in our Department.Material and Methods: Transperitoneal laparoscopic simple nephrectomy was performed in 12 patients between June 2010 and July 2011. Operation time, blood loss, the duration of the hospital stay and the follow-up, peroperative and postoperative complications were analyzed.Results: Of the patients, 5 41.7% were female and 7 58.3% were male. Their ages were between 12 and 72 mean 48 years . The renal pathology was on the right side in four patients 33.3% and the left side in eight patients 66.6% . There were atrophic kidney in 4 patients 33.3% , non-functioning hydronephrotic kidney secondary to stone disease in 6 patients 50% , multicystic dysplastic kidney in 1 patient 8.3% , and non-functioning kidney related to the vesicoureteral reflux in 1 patient 8.3% . No blood transfusion was performed in patients during the surgery, but it was converted to the open surgery in a patient because of uncontrollable bleeding. No postoperative complication was observed. The average duration of the operation was 100min 80-160 min . Average hospital stay was 3.2 days 2-6 days . Average length of follow-up was 6.8 months.Conclusion: Laparoscopic nephrectomy is a preferable method of treatment with the better toleration by the patients, the shorter hospital stay, the less postoperative pain relief and the more favourable cosmetic results

Keywords:

Laparoscopy, transperitoneal, nephrectomy,

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