T SEKMENLİ, N SEKMENLİ, M GÜNDÜZ, İ. ÇİFTCİ

Çocukluk Çağı Böbrek Taşları Tedavisinde İlk ESWL Deneyimlerimiz

Amaç: Bu çalışmada kliniğimizde böbrek taşı nedeniyle 8 çocuk hastada beden dışı şok dalga ile taş kırma(ESWL) uygulamalarımıza ait bulguları paylaş- mayı amaçladık Bulgular: 01.06.2012-01.12.2012 tarihleri arasında Konya Eğitim ve Araştırma Hastanesi Çocuk Cerrahisi kliniğinde böbrek taşlarına yönelik 8 çocuk hastada ESWL yapıldı. Hastalardan biri hariç, diğerlerinde tek taraflı böbrek taşı mevcuttu. Taş çapları 7-16 mm arasındaydı. Olgular ortalama 40 (18-108) aylık olup, 3ü kız 5i erkekdi. ESWL öncesinde genel anestezi altında böbrek taşı bulunan tarafa double J kateter yerleştirildi. ESWL uygulamalarının tümü genel anestezi altında yapıldı. İşlem, en çok 2000 şok ile ortalama 12 kV(kilovolt) gücünde Elmed(Ankara,Türkiye) cihazı ile yapıldı. Hastalar taş kırma uygulamasından 1 hafta sonra direkt üriner sistem grafisi ve üriner sistem ultrasonografisi ile takip yapıldı. Takipte kırılmamış olduğu tespit edilen taşlara, en fazla 3 seans ESWL uygulandı. Double J kateterin ortalama kalış süresi 22.8 gündü. Tüm hastalarımız 3. ve 6. aylarda kontrole çağı- rıldı, yapılan tetkiklerde böbrek taşına rastlanmadı. Sonuç: ESWL, çocuklarda üriner sistem taş hastalıklarında başarılı sonuçlarıyla güvenle kullanılabilecek minimal invaziv bir tedavi yöntemidir

Our First Experience Of ESWL In The Treatment Of Renal Stones In Childhood.

Objective: In this study we aimed to share our findings about ESWL (Extracorporeal Shock Wave Lithotripsy) application results in 8 children with renal stone in our clinic. Findings: Between 01.06.2012 and 01.12.2012 , we applied ESWL in a total of 8 children with kidney stones at our clinic. One patient had stones in bilaterally sides while the others had them one side. Stone diameters were between 7 and 16 mm. The cases were 40 (18-108) months old in average and three of them were girls while the other five were boys. Before ESWL , double J catheter was placed to the side where there was kidney stones under general anesthesia. All procedures were performed under general anesthesia The device named Elmed (Ankara, Turkey) which has maximal of 2000 shocks and average of 12kV(kilovolt) energy was used in each session. The patients were checked up one week after stone breaking operation by using plain urinary system film and urinary system ultrasonography . For the stones were found not broken yet during the check up, second and maximum third session ESWL applied. The average remaining time of double J catheter was 22.8 days. All our patients were called for control in third and sixth months, no stone was found during the examinations. Results: As a minimally invasive method, ESWL was found to be effective and safe in the treatment of childhood urinary system stone disease.

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