FATİH URUÇ, BEKİR ARAS, Ayhan KARAKÖSE, BİLAL ERYILDIRIM

Perkütan nefrolitotomi sonrası renal parankimal skar oluşumunun statik renal sintigrafi ile değerlendirilmesi

Amaç: Bu çalışmada böbrek taşı nedeni ile PNL operasyonu uygulanan 34 hastanın cerrahi sonrası böbrek hasarı DMSA renal sintigrafi ile değerlendirilmiştir. Gereç ve yöntem: Yaşları 14-65 arasında değişen 34 hasta (7 kadın, 27erkek) değerlendirildi. Bulgular: Bu görüntüleme yöntemi ile hastaların % 88,3’ünde renal kortikal skara rastlanmamıştır. Sonuç: PNL böbrek parankiminde hasar meydana getirmesine rağmen ciddi renal fonksiyon kaybına neden olmamaktadır. Bu yüzden üriner sistem taşlarının tedavisinde güvenle kullanılabilecek bir yöntemdir.

Assessment of renal parenchymal scarring after percutaneous nephrolithotomy with renal static scintigraphy

Objective: In this study, we evaluated post-operative renal damage in 34 patients who underwent PCNL for the treatment of renal calculi. Materials and methods: Thirty-four patients (7 female, 27 male) aged between 14-65 were evaluated. Results: In 88.3% of these patients, renal cortical scar formation is not assessed with DMSA renal scintigraphy. Conclusion: Although PCNL can cause renal parenchymal damage it doesnt lead to a severe loss of renal function. Therefore PCNL can be employed safely in the treatment of urinary tract calculi.

PDF

___

1.Matlaga B R, Assimos D G: Changing indications of open stone surgery. Urology, 2002; 59: 490-494.
2.Webb DR and Fitzpatrick JM: Percutaneous nephrolitotripsy: A functional and morphological study. Jour Urol 1985; 134: 587-591.
3.Tasca A, Angelo AD, Zattoni F, Ferrarese P, Calo L, Bui F, Cagnato P: Short-Term and stabilized effects of percutaneous nephrolithotomy on the kidney. Eur Urol 1988; 14:120-122.
4.Harbert J C, Andrich M P, Peller P J: The genitourinary system. In: Harbert J C, E Eckeiman W C, Nevmann R D. Eds. Nuclear Medicine, Diagnosis and, thrapy, New York: Thiame medical publishers inc. 1996: 713-743.
5.Smith AD and Lee WJ: Percutaneous stone removal procedures including irrigation. Urol Clin North Am, 1983; 10: 719.
6.Tanrıverdi O, Boylu U, Kendirci M, Kadıhasanoğlu M, Horasanlı K, Miroğlu C. The learning curve in the training of percutaneous nephrolithotomy. Eur Urol 2007; 52: 206-12.
7.Kroovand RL: Pediatric urolithiasis. Urol Clin North Am 1997, 24: 173.
8.Webb D R. Fitzpatrick J M: Percutaneous nephrolithotripsy: A functional and morphiogical study. J Urol, 1985; 134: 587-591.
9.Lottmann H B, Archambaud F, Hella! B, Pageyral B M, Cendron M: 99m Technetiumdimercapto-succinic acid renal skan in the evaluation of potential long-term renal parenchymal damage associated with extracorporeal shock wave lithotripsy in children. J Urol, 1998; 159: 521-524.
10.Walsh, Retik, Vaughan, Wein: Üriner taş hastalığının cerrahi tedavisi. Textbook Campbell, sf 3416- 3451.
11.Wilson W T, Husmann D A, Morris J S, Miller G L, Alexsander M, Preminger G M: A Comparison of the bioeffects of four different modes of stone therapy on renal function and morphology. J Urol, 1993; 150: 1267-1270.
12.CIayman. R V, Elbers J, Miller R P, Williamson J, Mckeel D, Wassynger W: Percutaneous nephrostomy: Assessment of renal damage associated with semi-rigid (24F) and balloon (36F) dilation. J Urol, 1987; 138: 203-206.
13.Marberger M, Stacki W, Hruby W, Kroiss A: Late sequelae of ultrasonic lithotripsy of renal calculi. J Urol 1985; 133: 170-173.
14.Louis S, Stevan B: Long-term renal functional effects of shock wave lithotripsy, percutaneous nephrolithotomy and combination therapy: A comparative study of patients with solitary kidney. J Urol 2001; 166: 33-37.
15.Mayo M E, Krieger J N, Rudd T G: Effect of percutaneous nephrostolithotomy on renal function. J Urol, 1985; 133: 167-169.
16.Streem SB, Zelch MG, Risius B et al: Percutaneous extraction of renal calculi in patients with soltitary kidneys. J Urol 1986, 27: 247.
17.Chatham J R, Dykes T E, Kennon W G, Schwatz B F: Effect of percutaneous nephrolithotomy on differential renal function as measured by mercaptoacetyl triglycine nuclear renography. Urology, 2002; 59(4); 522-524.
18.Prospective evaluation of the alterations in the morphology and vascular resistance of the renal parenchyma with color Doppler ultrasonography after percutaneous nephrolithotomy. Kiliç S, Oğuz F, Kahraman B, Altunoluk B, Ergin H. J Endourol. 2008 Apr; 22(4): 615-21.
19.James R, Thomas E, William G and Bradley F: Effect of percutaneous nephrolithotomy on differential renal function as measured by MAG3 nuclear renography. Adult Urol 2002, 59: 522-526.
20.Moskovitz B, Halachmi S, Sopov V, Burbara J, Horev N, Groshar D, Nativ O. Effect of percutaneous nephrolithotripsy on renal function: assessment with quantitative SPECT of (99m)Tc-DMSA renal scintigraphy. J Endourol. 2006 Feb; 20 (2):102-6.