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 simultane- ously 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 flex - ible cystoscopy in UPJ obstruction patients with kidney stones and patients with multiple renal stones is a feasible treatment option, with a high success rate.
Laparoskopik Pyeloplasti Ve Pyelolitotomi Operasyonlarında Taş Çıkarılmasında Fleksible Sistoskop Kullanımı
Amaç: Laparoskpik cerrahisinin üroloji ala- nından yaygınlaşması ile üreteropelvik bileşke darlığı (ÜPBD) ve böbrek taşlarının tedavisinde laparoskopik pyeloplasti ve laparoskopik pye - lolitotomi yaygın olarak kullanılmaktadır. İlave kaliks taşlarının çıkarılmasında bu yöntemlerle eş zamanlı olarak fleksible sistoskop kullanıla - bilmektedir. Biz çalışmamızda bu cerrahi prose- dürlerin kullanılabilirliğini değerlendirdik. Gereç ve Yöntemler: Şubat 2016-Ekim 2017 tarihleri arasında 7 hastaya laparoskopik pyeloplasti ve laparoskopik pyelolitotomi es - nasında 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 bir - likte böbrek taşları mevcuttu. 2 hastada ise renal pelvis taşına eşlik eden alt kaliks taşları mevcut - tu. Hastaların ortalama yaşları 36.8 (18-73) idi. Taşsızlık oranı % 85,7 olarak hesaplandı. Orta - lama operasyon süresi 153,5 (105-230) dakika olup, hastanede kalış süresi 4,4(3-7) gün idi. İntraopratif ve postoperatif herhangi bir komp - likasyon gelişmedi. Sonuç: UPBD’na böbrek taşı eşlik eden has- talarda ve multipl böbrek taşı olan hastalarda laparoskopik pyeloplasti ve pyelolitotomi ile eş zamanlı fleksible sistoskop kullanımı yüksek ba- şarı oranı ile kullanılabilir bir tedavi seçeneğidir.
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