Renal pelvis taşlarının rijid üreterorenoskopi ile tedavisi
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Dosyalar
Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi Tıp Fakültesi Dergisi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızdaki amacımız, rijit üreterorenoskopla renal pelvis taşlarının tedavi edilebilirliğini değerlendirmek.
Gereç ve yöntemler: Çalışmaya Ocak 2009 ve Mart 2010 tarihleri arasında, renal pelvis taşı (2 cm veya daha küçük) nedeniyle ESWL (Extracorporeal Shock Wave Lithotripsy) uygulanan, ancak ESWL tedavisi ile taşı kırılamayan veya ESWL tedavisi istemeyen toplam 13 hasta dahil edildi. Hastalara diğer tedavi alternatifleri anlatıldı. Rijit üreterorenoskop ve pnömotik litotiriptör ile renal pelvis taşları kırılarak tedavi edildi. Ameliyat edilen hastaların hepsine Double-J üreteral stent takıldı.
Bulgular: Hastaların ortalama yaşı 53±4.23 (min: 33-mak: 73) idi. Ortalama operasyon süresi 42.30+14.13 dakika (min: 35-mak: 55) idi. 6 hastada küçük parçalar 3 hafta içinde kendiliğinden düştü. 3 hastada, üreterde taş yolu oluştu, 2 ay sonra tekrar üreterorenoskopi yapıldı. 1 hastada, üreterde düşmeyen büyük parça taş için üreterorenoskopi yapıldı. 3 hastada, yetersiz kırılan taş parçalarının bir kısmı kalikslere migrate oldu. Tüm bu işlemlerden sonra, çalışmaya dahil edilen hastalardaki başarı oranı %77 idi. Hastalarda gözlenen komplikasyonlar: 2 hastada post-op 1 gün süren, ancak transfüzyon gerektirmeyen, hematüri oldu, 1 hastada yüksek ateş oldu, 1 hastamızda ise şiddetli dizüri oldu.
Sonuç: Böbrek taşlarının tedavisinde perkütan nefrolitotomi, fleksible üreterorenoskopi, açık cerrahi gibi çeşitli tedavi alternatifleri vardır. Bu tedavi alternatiflerine ek olarak, renal pelvis taşlarında rijit üreterorenoskopi, düşük maliyetli ve etkin bir tedavi alternatifi olarak düşünülebilir.
Aim: To evaluate the treatment of renal pelvic stones with rigid ureterorenoscopy. Meterial and Methods: Total of 13 patients were evaluated between January 2009 and March 2010. Stones in all patients were equal to or less than 2 cm. The patients who refused ESWL (Extracorporeal Shock Wave Lithotripsy) treatment or those who have failed in ESWL treatment were included in the study. Other treatment options were explained to patients. Rigid ureterorenoscopy was performed with pneumatic lithotripter. Double-J uretheral stent was applied in all the cases. Results: The mean age of the patients was 53±4.23 years (minimum: 33 and maximum: 73 years). The average operation time was 42.3±14.2 minutes (minimum: 35 and maximum: 55 minutes). Small stone fragments were passed spontaneously in six patients in three weeks. Stone way was created in three patients and we performed re-ureterorenoscopy in these cases after two weeks. The fragments of small stones migrated to the renal calyxes in three cases. Stone-free rate was 77% after all the procedures. Observed complications: hematuria in two patients cases in postoperative two days (no blood transfusion needed); high fever in one patient and severe dysuria in one patient. Conclusion: There are treatment options such as percutaneous nephrolithotomy, flexible ureterorenoscopy, open surgery for treatment of renal stones. The rigid ureterorenoscopy can be considered as a low cost and effective treatment in the renal pelvic stones.
Aim: To evaluate the treatment of renal pelvic stones with rigid ureterorenoscopy. Meterial and Methods: Total of 13 patients were evaluated between January 2009 and March 2010. Stones in all patients were equal to or less than 2 cm. The patients who refused ESWL (Extracorporeal Shock Wave Lithotripsy) treatment or those who have failed in ESWL treatment were included in the study. Other treatment options were explained to patients. Rigid ureterorenoscopy was performed with pneumatic lithotripter. Double-J uretheral stent was applied in all the cases. Results: The mean age of the patients was 53±4.23 years (minimum: 33 and maximum: 73 years). The average operation time was 42.3±14.2 minutes (minimum: 35 and maximum: 55 minutes). Small stone fragments were passed spontaneously in six patients in three weeks. Stone way was created in three patients and we performed re-ureterorenoscopy in these cases after two weeks. The fragments of small stones migrated to the renal calyxes in three cases. Stone-free rate was 77% after all the procedures. Observed complications: hematuria in two patients cases in postoperative two days (no blood transfusion needed); high fever in one patient and severe dysuria in one patient. Conclusion: There are treatment options such as percutaneous nephrolithotomy, flexible ureterorenoscopy, open surgery for treatment of renal stones. The rigid ureterorenoscopy can be considered as a low cost and effective treatment in the renal pelvic stones.
Açıklama
[Turgut Özal Tıp Merkezi Dergisi, (2014).21 (1)]
Anahtar Kelimeler
Rijit Üreterorenoskopi, Böbrek Pelvis Taşı, Tedavi, Rjid Ureterorenoscopy, Renal Pelvic Stone, Treatment
Kaynak
Turgut Özal Tıp Merkezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
21
Sayı
1
Künye
Ağlamış, E.,Gür, E.,Beytur, A.,Taşdemir, C.,Yücel, M. Özgür.,(2014).Renal pelvis taşlarının rijid üreterorenoskopi ile tedavisi.Turgut Özal Tıp Merkezi Dergisi, 21 (1).1-3 ss.