MANSUR DAĞGÜLLİ, Mehmet Mazhar UTANĞAÇ, ONUR DEDE, Mehmet Nuri BODAKÇI, Necmettin PENBEGÜL, Ahmet Ali SANCAKTUTAR, Suleyman CAKMAKCI, Yaşar BOZKURT

PNL ve açık böbrek taşı cerrahisi sonrası rekürrens

Amaç: Nefrolitiazis nedeniyle perkütan nefrolitotripsi PNL veya açık cerrahi geçiren hastalarda taş rekürrens oranını karşılaştırmak.Gereç ve Yöntemler: Ocak 2006-Mayıs 2009 tarihleri arasında cerrahi tedavi uygulanan böbrek taşı tanılı hasta geriye dönük olarak incelendi. Toplam 38 hasta çalışmaya alındı . Grup 1 n:20 hastaya açık cerrahi uygulanırken Grup 2 n:18 hastaya ise PNL uygulandı. Cerrahi sonrası non-opak ve rezidü taşı olan hastalar çalışma dışı bırakıldı. Taş taraması için idrar analizi, radyografi ve non-kontrast bilgisayarlı tomografi yapıldı. Hastaların yaş, cinsiyet, hastanede kalış süresi, preoperatif taş yükü, postoperatif takip süresi ve postoperatif taş yükü kaydedildi.Bulgular: Grup 1 ve grup 2 deki erkek / kadın oranı sırasıyla 11/9 ve 10/8 dir. Yaş ortalaması 1. grupta 41,9 ± 13,58 ve 2. grupta 36,22 ± 14,3 yıl idi. Ameliyat öncesi taş yükü PNL grubunda 329,46 ± 249,66 mm2 iken açık cerrahi grubunda 390,72 ± 200,12 mm² idi. Taş rekürrensi açık cerrahi grubunda sadece % 20 iken PNL grubunda % 61olarak saptandı. Ameliyat sonrası kontrollerde taş yükü Grup 2’de Grup 1’e nazaran anlamlı derecede daha yüksek bulundu p= 0.40 . Sonuç: PNL son zamanlarda böbrek taşı ameliyatları için daha sık kullanılır olmuştur. Taş nüks oranı rezidüel fragmanlar nedeniyle perkütan nefrolitotripsi sonrası artabilir

Anahtar Kelimeler:

PNL, nüks taş, böbrek taşı, perkütan nefrolitotripsi

Recurrence after PNL and open renal stone surgery

Objective: To compare the rate of stone recurrence in patients who underwent percutaneous nephrolithotripsy PNL or open surgery because of nephrolithiasis. Material and Methods: Between January 2006-May 2009 with diagnosis of nephrolithiasis who underwent surgical treatment were reviewed retrospectively. Totally 38 patients were included to study. Group 1 n: 20 underwent open surgery, while Group 2 n: 18 patients underwent PNL. The patients whom have nonopaque and residual stones after surgery were excluded from the study. By the controls urine analysis, plain radiography and non-contrast computer tomography were performed for screening stones. Patients’ age, gender, duration of hospital stay, preoperative stone burden, postoperative follow-up period and postoperative stone burden were recorded. Results: The ratio of male/female in group 1 and group 2 is 11/9 and 10/8 respectively. The mean age was 41,9±13,58 in group 1 and 36,22±14,3 years in group 2. Preoperative stone burden was 329,46±249,66mm2 in PNL group while 390,72±200,12mm2 in open surgery group. Stone recurrence was detected in 61 % 11/18 of the patients treated with PNL, while only in 20 % 4/20 of the patients in the open surgery group. Postoperative control stone burden was significantly higher in group 2 than in group 1 p=0.40 . Conclusion: PNL has been used more frequently for renal stone surgeries recently. The stone recurrence rate may increase after percutaneous nephrolithotripsy due to insignificant residual fragments

Keywords:

PNL, Stone recurrence, urolithiasis, percutaneous nephrolithotripsy,

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