Çocuklarda ve Erişkinlerde Perkütan Nefrolitotomi Sonrası Anjioembolizasyon İhtiyacının Değerlendirilmesi

Year 2025, Volume: 35 Issue: 2, 226 - 231, 30.04.2025

Mehmet Sarıkaya , Emre Kandemir

https://doi.org/10.54005/geneltip.1552117

Abstract

Özet
Amaç: Perkütan nefrolitotomi (PNL) operasyonu sonrası gelişebilen şiddetli ve dirençli kanamalar ve buna bağlı gerekebilen transkatater anjiyoembolizasyon (TAE) ihtiyacının değerlendirilmesi amaçlandı.
Gereç ve Yöntem: Son sekiz yılda iki klinikte gerçekleştirilen PNL operasyonları retrospektif olarak değerlendirildi. İnatçı ve şiddetli kanaması olan ve TAE ihtiyacı olan hastalar ameliyat öncesi, ameliyat sırası ve ameliyat sonrası bulgular açısından değerlendirildi.
Bulgular: TAE uygulanan hasta sayısı 14, ortalama yaş 40.9, ortalama ameliyat süresi 80.1 dakika, floroskopi süresi 7.7 dakika (2.2-16 dakika) izlendi. Hastaların ortalama hematokrit düşüşü %11,8 (%4,4-22,1), ameliyattan embolizasyona kadar geçen süre ortalama 5,6 gün (1-11 gün), ortalama nefrostomi süresi 3,8 gün (1-7) ve ortalama hastanede kalış süresi 4,9 gün (2-10) olarak bulundu. 1 hastada 12 Fr erişim kılıfı, 1 hastada 20 Fr erişim kılıfı, 1 hastada 26 Fr erişim kılıfı ve 11 hastada 30 Fr erişim kılıfı kullanıldı.
Sonuç: PNL sonrası müdahale gerektiren kanama iyi yönetilmesi ve tedavi edilmesi gereken bir durumdur. Hastanın özellikleri, PNL tekniği ve per-operatif bulgular bu durumu öngöremez. Kesin sonuçlar için daha büyük ölçekli prospektif randomize çalışmalara ihtiyaç vardır.

Keywords

Perkutan nefrolitotomi, Nefrolitiazis, Transkateter Anjioembolizasyon, Floroskopi

EVALUATİON OF THE NEED FOR ANGİOEMBOLİZATİON AFTER PERCUTANEOUS NEPHROLİTHOTOMY İN CHİLDREN AND ADULTS

Abstract

Abstract
Aims: Perkütan nefrolitotomi (PNL) operasyonu sonrası gelişebilen şiddetli ve dirençli kanamalar ve buna bağlı gerekebilen transkatater anjioembolizasyon (TAE) ihtiyacının değerlendirilmesi amaçlandı .
Methods: PNL operations performed in two clinics in the last eight years were evaluated retrospectively. Patients with persistent and severe bleeding and a need for TAE were assessed in terms of preoperative, perioperative, and postoperative findings.
Results: The number of patients who underwent TAE was 14. The mean age was 40.9 years. The mean duration of operation was 80.1 minutes. The duration of fluoroscopy was 7.7 minutes (2.2-16 min). The mean hematocrit decrease of the patients was 11.8% (4.4-22.1%). The mean time from surgery to embolization was 5.6 days (1-11 days). Tthe mean nephrostomy time was 3.8 days (1-7), and the mean hospital stay was 4.9 days (2-10). 12 Fr access sheath was used in 1 patient, 20 Fr access sheath in 1 patient, 26 Fr access sheath in 1 patient, and 30 Fr access sheath in 11 patients.
Conclusions: Bleeding requiring intervention after PNL is a condition that should be managed and treated well. The patient's characteristics, PNL technique, and per-operative findings cannot predict this condition. Larger scale prospective randomized studies are needed for definitive results.

Keywords

percutaneous nephrolithotomy, Nephrolithiasis, transcatheter angioembolization, fluoroscopy

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