PRİMER İNCE BAĞIRSAK TÜMÖRLERİ: ÇEYREK YÜZYILLIK KLİNİKOPATOLOJİK DENEYİM

Year 2014, Volume: 18 Issue: 4, 81 - 87, 01.12.2014

İbrahim Halil Bozkurt Tarık Yonguç Özgü Aydoğdu Serkan Yarımoğlu Tansu Değirmenci Ömer Koraş Bülent Günlüsoy Süleyman Minareci

Abstract

Kliniğimizde böbrek taşı nedeniyle retrograd intrarenal cerahi RİRC uygulanan ilk 41 olgunun sonuçlarını sunmak. Temmuz 2013 ile Haziran 2014 tarihleri arasında Bozyaka Eğitim ve Araştırma Hastanesi Üroloji kliniğinde böbrek taşına yönelik RİRC uygulanan 41 27 erkek, 14 kadın hastanın verileri prospektif olarak kaydedildi. Tüm hastalar ameliyat öncesi ayrıntılı bir hikaye, rutin labarotuvar testleri ve idrar kültürü ile değerlendirildi. İdrar kültüründe üreme olan hastalar antibiyotik tedavisi sonrası kültürler temiz olunca ameliyata alındı. Olguların 14’ü kadın, 27’si erkek, yaş ortalaması 48.6 yıl idi. Ortalama taş boyutu 14.1 mm idi. İşlemlerin 2 % 4.8 tanesinde üreteral giriş kılıfı kullanılırken, kalan 39 % 95.2 hastada işlem kılıfsız uygulandı. Ortalama operasyon süresi 73.1 dk, floroskopi süresi ise 6.9 sn idi. Bütün hastalar ameliyat sonrası 1. günde taburcu edildi. Olguların 1. ay kontrollerinde 35 inde %85.3 taşsızlık sağlanırken, 5 tanesinde %12.1 rezidü taş, 1 tanesinde de %2.4 klinik önemsiz taş saptandı. Takiplerde 4 hasta antibiyotiklerle kontrol altına alınan üriner enfeksiyon saptandı, hiçbir hastada sepsis gelişmedi. İki cm altındaki böbrek taşlarının tedavisinde RİRC işlemi güvenle uygulanabilen, taşsızlık, kısa hastanede kalış süresi ve düşük komplikasyon oranıyla günümüzde tercih sebebi olan minimal invaziv yöntemdir

Keywords

böbrek taşı, fleksible üreteroskop, retrograd intrarenal cerrahi

PRIMARY SMALL INTESTINE TUMORS: A QUARTER CENTURY OF CILINICOPATHOLOGICAL EXPERIENCE

Abstract

To present the outcome of first 41 cases who had undergone retrograde intrarenal surgery RIRS for renal stones in our clinic. The data of 41 patients who underwent RİRC for renal stones in our clinic between July 2013 and June 2014 were noted prospectively. All patients were evaluated with a detailed medical history, routine labarotory tests and urine culture preoperatively. If the urine culture was positive, antibiotic therapy was given and the operation was postponed until a negative culture was achieved. Study population consisted of 14 female and 27 male patients with a mean age of 48.6 years . Mean stone size was 14.1 mm. Access sheaths were used in 2 4.8 % cases, while in 39 95.2 % cases the procedure was applied without using an access sheath. Mean operative, and fluoroscopy times were 73.1 minutes, and 6.9 seconds, respectively. All patients were discharged at postoperative day 1. At 1st month follow-up stone-free rate was achieved in 35 85.3% patients. Clinically insignificant residual stone fragments were detected in 1 2.4% , and residual stones in 5 12.1% . During follow-up period, non-complicated urinary tract infection developed in 4 patients . But none of the patients had developed sepsis.RIRS is a safe and effective minimally invasive method for the treatment of renal stones less than 2 cm with high stone-free rates, low complication rate and short hospitalization time

Keywords

renal stone, flexible ureteroscope, retrograde intrarenal surgery

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