Hasan TURGUT, MEHMET AKİF DİRİ, MURAT BAĞCIOĞLU, TOLGA KARAKAN, Cankon GERMİYANOĞLU

Perkütan nefrolitotomi operasyonlarında kullanılan balon ve amplatz dilatasyon tekniklerinin karşılaştırılması

Amaç: Çalışmamızda kliniğimizde perkutan nefrolitotomi PNL operasyonlarında, amplatz dilatatör ve balon dilatatör kullandığımız vakaları karşılaştırdık. Gereç ve Yöntemler: Temmuz 2008–Eylül 2011 tarihleri arasında, Ankara Eğitim ve Araştırma Hastanesi 2. Üroloji kliniğinde uygulanan PNL operasyonları iki gruba ayrılarak, operasyon sırasında kullanılan dilatasyon teknikleri belirlendi. Çalışmaya toplam 273 hasta 173 erkek ve100 kadın 320 renal ünite dahil edildi. 320 renal ünitenin 204’ünde %63.75 amplatz, 116’sında %36.25 balon dilatasyon tekniği kullanıldı. Hastalar postoperatif 1.gün ve 3.ay taşsızlık oranı, hemoglobin düşüşü, hastanede yatış süresi, cerrahi süreleri, skopi süresi açısından retrospektif olarak karşılaştırıldı. Bulgular: Balon ve amplatz kullanılan hastalar karşılaştırıldığında ortalama hemoglobin düşüşü Amplatz: 1,31Ü - Balon: 1,03Ü , cerrahi süreleri Amplatz: 64,41dk.- Balon:57,26 dk. , skopi süresi Amplatz: 162,45 sn. - Balon: 129,27 sn. arasında istatistiksel olarak anlamlı fark tespit edildi p0.05 . Sonuç: Balon dilatatörün ekonomik açıdan pahallı oluşu, kullanımının tecrübe gerektirmesi ve tek kullanımlık olması dezavantajlarıdır. Amplatz dilatatörün birden çok kullanılabilir olması, balon dilatatöre göre daha ucuz olması gibi avantajları mevcuttur ve tecrübeli hekimler tarafından uygulandığında cerrahi süresi, kanama miktarı ve skopi süresi daha düşük derecelerde tutulabilir

Anahtar Kelimeler:

balon dilatasyon, amplatz dilatasyon, perkütan nefrolitotomi

Comparison of amplatz and balloon dilatation techniques in percutaneous nephrolithotomy cases

Objectives: In our study, we compared the percutaneous nephrolithotomy cases with amplatz dilatation to the cases with balloon dilatation. Materials and Methods: Our study was carried out at Ankara Training and Research Hospital, 2. Urology deparment, from July 2008 to September 2011. Percutaneous nephrolithotomy cases were divided in to two groups and different dilatation techniques were used for each group. 273 patients 173 male and 100 female and 320 renal unites were included in to the study. Amplatz dilatation technique was used in 204 of 320 renal unites %63.75 and balloon dilatation technique was used in 116 cases %36.25 . Stone free rates for the first postoperative day and the third month, hemoglobine decrease, hospitalization time and scopy time for all cases were compared in a retrospective design. Results: In the comparison of the cases with amplatz and balloon dilatation, the mean hemoglobine decreases Amplatz: 1,31 u.- Balloon: 1,03 u. , mean operation time Amplatz: 64,41 min. – Balloon: 57,26 min. and mean scopy time Amplatz: 162,45 sec. – Balloon: 129,27 sec. were found as statistically significant p0.05 . Conclusion: The balloon dilatation technique is expensive, single use and requires experience. These are the disadvantages of this technique. Amplatz dilatation has advantages like it is re-usable and cheaper than balloon. Also, amplatz technique reduces operation time, blood loss and scopy time in experienced hand.

Keywords:

balloon dilatation, amplatz dilatation, perkutaneous nephrolitotomi,

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