At nalı böbrekte perkütan nefrolitotomi başarısını etkileyen faktörler
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Perkütan nefrolitotomi yapılan at nalı böbrek hastalarında, cerrahi taşsızlık oranının etkileyen faktörlerin değerlendirilmesi amaçlanmıştır. Materyal ve metot: 2009-2023 yılları arasında İnönü Üniversitesi Turgut Özal Tıp merkezinde kliniğimize başvuran 188 at nalı böbrek hastası tespit edilmiştir. Bu hastaların 19'una 24 ünit perkütan nefrolitotomi operasyonu gerçekleştirilmiştir. Her cerrahi ünit birbirinden bağımsız olarak değerlendirilmiştir. Hastalar post-op rezidu taş izlenen 9 ünit Grup A, post-op rezidu taş izlenmeyen 15 ünit Grup B olarak ikiye ayırılmıştır. Gruplar arası; yaş, cinsiyet, cerrahi öykü, ek komorbiditeler, renal anomaliler, taş alanları, taş sayısı, taş lokasyonu, Guy's Stone skorlaması, Houns-field üniti, PNL çeşidi ve puncture bölgesi, taş cilt mesafesi, hospitalizsyon süresi farklılıklar retrospektif olarak değerlendirilmiştir. Çalışmamıza yetişkin ve pediatrik yaş gurubundan at nalı böbreğe sahip olup perkütan nefrolitotomi yapılan pre-operatif ve post-operatif takip ve tedavileri kliniğimizde düzenlenen hastalar dahil edilmiştir. Bulgular: Grup A'da 9 ünit, Grup B' 15 ünit karşılaştırılmıştır. Gruplar arası demografik veri karşılaştırmasında; yaş, cinsiyet, ek hastalıklar ve renal anomaliler arasında istatiksel farklılık izlenmemiştir(p>0,05). Gruplar arası geçirilmiş cerrahi öykü istatiksel olarak anlamlı izlenmiştir(p<0,05). Gruplar arası pre-operatif taş özellikleri karşılaştırmasında; taş sayısı, taş lokasyonu, Guy'stone skorlaması, ve taşın Houns-field ünite açısından gruplar arası anlamlı farklılık izlenmemiştir(p>0,05). Gruplar arası taş alanı farklılığı istatiksel olarak anlamlı bulunmuştur(p<0,05). Gruplar arası intra-operatif ve post-operatif farklılıkların karşılaştırmasında; PNL çeşidi ve puncture bölgesi, taş cilt mesafesi, post-op nefrostomi, kompolikasyon ve hospitalizasyon süresi gibi parametrelerde istatiksel fark izlenmemiştir(p>0,05) Anlamlı çıkan taş alanı ve geçirilmiş cerrahi öykü gibi faktörlerin lojistik regresyon analizinde taş alanının tek başına bağımsız bir olduğu izlenmiştir(p<0,05). Sonuç: Perkütan nefrolititomi at nalı böbrek hastalarında güvenle uygulanabilir bir cerrahi çeşididir ve çalışmamızda taş alanı parametresinin tek başına bağımsız bir faktör olarak cerrahi başarıyı etkilediği görülmüştür. Anahtar kelimeler; Perkütan nefrolitotomi, at nalı böbrek, taşsızlık oranı
Objective: It was aimed to evaluate the factors affecting the surgical stone-free rate in horseshoe kidney patients who underwent percutaneous nephrolithotomy. Materials and methods: 188 horseshoe kidney patients who applied to our clinic at İnönü University Turgut Özal Medical Center between 2009 and 2023 were identified. A 24-unit percutaneous nephrolithotomy operation was performed on 19 of these patients. Each surgical unit was evaluated independently. The patients were divided into two: Group A, 9 units with post-operative residual stones, and Group B, 15 units with no post-operative residual stones. Between groups; Differences in age, gender, surgical history, additional comorbidities, renal anomalies, stone areas, number of stones, stone location, Guy's Stone scoring, Houns-field unit, PNL type and puncture area, stone-to-skin distance, and hospitalization time were evaluated retrospectively. Our study included adult and pediatric patients with horseshoe kidneys who underwent percutaneous nephrolithotomy and whose pre-operative and post-operative follow-up and treatments were arranged in our clinic. Results: 9 units in Group A and 15 units in Group B were compared. In the comparison of demographic data between groups; No statistical difference was observed between age, gender, additional diseases and renal anomalies (p>0.05). Previous surgical history was statistically significant between groups (p<0.05). In the comparison of pre-operative stone characteristics between groups; No significant difference was observed between the groups in terms of stone number, stone location, Guy'stone scoring, and Houns-field unit of the stone (p>0.05). The difference in stone area between groups was found to be statistically significant (p<0.05). In the comparison of intra-operative and post-operative differences between groups; No statistical difference was observed in parameters such as PNL type and puncture area, stone-to-skin distance, post-operative nephrostomy, complications and hospitalization time (p>0.05). In the logistic regression analysis of significant factors such as stone area and previous surgical history, it was observed that stone area was an independent factor (p<0.05). Conclusion: Percutaneous nephrolithotomy is a type of surgery that can be safely applied in horseshoe kidney patients, and in our study, it was observed that the stone area parameter alone affected surgical success as an independent factor. Keywords; Percutaneous nephrolithotomy, horseshoe kidney, stone-free rate
Objective: It was aimed to evaluate the factors affecting the surgical stone-free rate in horseshoe kidney patients who underwent percutaneous nephrolithotomy. Materials and methods: 188 horseshoe kidney patients who applied to our clinic at İnönü University Turgut Özal Medical Center between 2009 and 2023 were identified. A 24-unit percutaneous nephrolithotomy operation was performed on 19 of these patients. Each surgical unit was evaluated independently. The patients were divided into two: Group A, 9 units with post-operative residual stones, and Group B, 15 units with no post-operative residual stones. Between groups; Differences in age, gender, surgical history, additional comorbidities, renal anomalies, stone areas, number of stones, stone location, Guy's Stone scoring, Houns-field unit, PNL type and puncture area, stone-to-skin distance, and hospitalization time were evaluated retrospectively. Our study included adult and pediatric patients with horseshoe kidneys who underwent percutaneous nephrolithotomy and whose pre-operative and post-operative follow-up and treatments were arranged in our clinic. Results: 9 units in Group A and 15 units in Group B were compared. In the comparison of demographic data between groups; No statistical difference was observed between age, gender, additional diseases and renal anomalies (p>0.05). Previous surgical history was statistically significant between groups (p<0.05). In the comparison of pre-operative stone characteristics between groups; No significant difference was observed between the groups in terms of stone number, stone location, Guy'stone scoring, and Houns-field unit of the stone (p>0.05). The difference in stone area between groups was found to be statistically significant (p<0.05). In the comparison of intra-operative and post-operative differences between groups; No statistical difference was observed in parameters such as PNL type and puncture area, stone-to-skin distance, post-operative nephrostomy, complications and hospitalization time (p>0.05). In the logistic regression analysis of significant factors such as stone area and previous surgical history, it was observed that stone area was an independent factor (p<0.05). Conclusion: Percutaneous nephrolithotomy is a type of surgery that can be safely applied in horseshoe kidney patients, and in our study, it was observed that the stone area parameter alone affected surgical success as an independent factor. Keywords; Percutaneous nephrolithotomy, horseshoe kidney, stone-free rate
Açıklama
Anahtar Kelimeler
Üroloji, Urology
