Serkan YARIMOĞLU, SALİH POLAT, İbrahim Halil BOZKURT, Tarık YONGUÇ, Özgü AYDOĞDU, ERHAN AYDIN, Ertuğrul ŞEFİK, Tansu DEĞİRMENCİ

Perkütan nefrolitotomi tedavi başarısını ve komplikasyonlarını öngörmek için kullanılan GUY taş skorlama sisteminin validasyonu

Giriş: Bu çalışmada böbrek taşı nedeniyle perkutan nefrolitotomi uygulanan hastalarda tedavi başarısı ve komplikasyonları öngörmek için kullanılan Guy Skorlama Sistemin(GSS)'nin validasyonunun yapılması amaçlanmıştır.Gereç ve Yöntem: Ocak 2012 ile Agustos 2015 tarihleri arasında İzmir Bozyaka Eğitim ve Araştırma Hastanesi Üroloji Kliniği'nde perkütan nefrolitotomi(PNL) operasyonu uygulanan 567 hasta retrospektif olarak değerlendirildi. Bu hastalarda 2 (iki) ve üzeri giriş yapılan 60 hasta ile operasyon esnasında exitus gelişen 1 hasta çalışmaya dahil edilmedi. Tüm hastalar operasyon öncesi kontrastsız tüm abdomen spiral bilgisayarlı tomografi (BT) ile degerlendirildi.Hastalar postoperatif 1. aydaki kontrollerinde direkt üriner sistem grafisi (DÜSG) ile değerlendirildi. DÜSG'de şüpheli opasite olan hastalar ve/veya semptomatik hastalar ve taşı opak olmayan hastalar sırasıyla üriner USG (ultrasonografi) ve kontrastsız tüm batın BT (bilgisayarlı tomografi) ile değerlendirildi. Semptomları olmayan ve < 4 mm taşı olan hastalarda taşsızlık sağlandığı kabul edildi. GSS her hastaya tek tek uygulandı. Bu skorlama sistemi ile taşsızlık oranları, operasyon süreleri, skopi süreleri, hastanede kalış süreleri korele edildi. Postoperatif komplikasyonlar modifiye Clavien skorlama sistemine göre sınıflandırıldı ve Guy taş skorları ile ilişkisi değirlendirildi.Bulgular: Ortalama Guy taş skoru 2,08±0,9 olarak saptandı. Toplam taşsızlık saptanan hasta sayısı 394 (%77.9) idi. Ortalama taş boyutu 502,01 ± 517,5 mm² olarak hesaplandı. Perkütan nefrolitotomi uygulanan hastaların 112 (%22,1)'sinde rezidü taş kaldığı tespit edildi. Guy taş skoru ile operasyon süresi (p

External validation of GUY score system to predict treatment success and complications of percutaneous nephrolithotomy

Introduction: We aimed to validate Guy Scoring System(GSS) to predict treatment success and complications in patients who underwent percutaneous nephrolithotomy for kidney stones. Materials and Methods: We retrospectively analyzed 568 patients who underwent PNL from January 2012 to August 2015 at Izmir Bozyaka Research And Training Hospital Urology Department for kidney stones. 60 patients who had multiple (two or more) access tracts were excluded from the study and 1 patient was excluded because of death while operating. All patients were evaluated with non-contrast spiral abdomen computed tomography (CT) scan before the operation. All patients analysed with direct urinary system graphs (DUSG) after one month from the surgery. Patients who had symptoms or opacity in DUSG were evaluated with urinary system USG and patients who had nonopacity stones were evaluated with abdomen CT scan. Patients who had no symptoms or less than 4 mm renal calculi were accepted stone free. All patients evaluated one by one with GSS. Stone-free status, operation time, fluoroscopy time and length of hospital stay were correlated with GSS. Postoperative complications were scored with Modified Clavien scoring systems and correlated with GSS. Results: The mean Guy stone score was 2,08±0,9 Overall stone free rates was 394 (%77.9). The mean stone size is calculated 502,01 ± 517,5 (55-2869) mm². 112 (%22,1) of the patients had residue stone. There were a positive correlation between GSS with stone-free rates (p

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