Alper BİTKİN, Mustafa AYDİN, Ebubekir AKGUNES, Mevlut KELES, Mustafa Kemal ATİLLA, Lokman IRKİLATA

Laparoskopik Pyeloplasti Ve Pyelolitotomi Operasyonlarında Taş Çıkarılmasında Fleksible Sistoskop Kullanımı

Amaç: Laparoskpik cerrahisinin üroloji alanından yaygınlaşması ile üreteropelvik bileşke darlığı (ÜPBD) ve böbrek taşlarının tedavisinde laparoskopik pyeloplasti ve laparoskopik pyelolitotomi yaygın olarak kullanılmaktadır. İlave kaliks taşlarının çıkarılmasında bu yöntemlerle eş zamanlı olarak fleksible sistoskop kullanılabilmektedir. Biz çalışmamızda bu cerrahi prosedürlerin kullanılabilirliğini değerlendirdik.Gereç ve Yöntemler: Şubat 2016-Ekim 2017 tarihleri arasında 7 hastaya laparoskopik pyeloplasti ve laparoskopik pyelolitotomi esnasında fleksible sistoskop ile taş çıkarılması işlemi uygulandı. Hastaların operasyon süresi, kan kaybı, hastanede kalış süresi, peroperatif ve postoperatif komplikasyonlar ve takip süreleri değerlendirildi.Bulgular: 7 hastanın 5’inde UPBD ile birlikte böbrek taşları mevcuttu. 2 hastada ise renal pelvis taşına eşlik eden alt kaliks taşları mevcuttu. Hastaların ortalama yaşları 36.8 (18-73) idi. Taşsızlık oranı % 85,7 olarak hesaplandı. Ortalama operasyon süresi 153,5 (105-230) dakika olup, hastanede kalış süresi 4,4(3-7) gün idi. İntraopratif ve postoperatif herhangi bir komplikasyon gelişmedi.Sonuç: UPBD’na böbrek taşı eşlik eden hastalarda ve multipl böbrek taşı olan hastalarda laparoskopik pyeloplasti ve pyelolitotomi ile eş zamanlı fleksible sistoskop kullanımı yüksek başarı oranı ile kullanılabilir bir tedavi seçeneğidir.

Anahtar Kelimeler:

Laparoskopik pyeloplasti, laparoskopik pyelolitotomi, fleksible sistoskopi

Use of Flexible Cystoscope in Removal of Stone in Laparoscopic Pyeloplasty and Pyelolithotomy

Objective: Laparoscopic pyeloplasty and laparoscopic pyelolithotomy are widely used in the treatment of ureteropelvic junction (UPJ) obstructions and renal stones in the urology field. Flexible cystoscopy can be used simultaneously with these methods for removal of calyceal stones in patients with UPJ obstructions. The present study assessed the usefulness of these surgical procedures .Material and Methods: Between February 2016 and October 2017, 7 patients underwent stone removal with a flexible cystoscope during laparoscopic pyelolithotomy and laparoscopic pyeloplasty. The durations of the operations and hospital stays, blood loss, preoperative and post- operative complications, and follow-up times were evaluated.Results: Five of seven patients had renal stones with UPJ obstruction. Two patients had calyceal stones in the lower calyx , in addition to renal pelvic stones. The mean age of the patients was 36.8 (18–73) years. The stone-free rate was 85.7%. The mean duration of the operation was 153.5 (105–230) min, and the duration of the hospital stay was 4.4 (3–7) days. There were no intraoperative or postoperative complications.Conclusion: Laparoscopic pyeloplasty and pyelolithotomy, with simultaneous use of flexible cystoscopy in UPJ obstruction patients with kidney stones and patients with multiple renal stones is a feasible treatment option, with a high success rate.

Keywords:

Laparoscopic pyelolithotomy, laparoscopic pyeloplasty, fleksible cystoscopy,

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