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Results of percutaneous nephrolithotomy performed in a regional state hospital

Year 2011, , 371 - 374, 01.12.2011
https://doi.org/10.5799/ahinjs.01.2011.04.0074

Abstract

Aim: The aim of this study was to evaluate the results of percutaneous stone surgery that performe in a regional state hospital. Materials and methods: We retrospectively analyzed 183 percutaneous nephrolithotomy (PNL) performed cases that treated at our clinic between June 2010 and July 2011. After necessary laboratory and radiological investigations, we performed PNL for the patients those diagnosed as having stones needed surgery. After surgery, we investigated radiologically whether residual stone fragments remained or not. When there were residual stone fragments (bigger than 4 mm), we performed ESWL, repeated percutaneous interventions and surveillance protocols. In six patients, open surgery was needed during PNL. Results: Of the totally 183 patients underwent PNL at our clinic, 102 were male and 81 were female. The mean age was 37.6 and mean stone burden was 35.5 mm2. Stone-free rate was 75.4% and the rate of the patients who have residual stones (bigger than 4mm) was 25.7%. Stone free rates were 95% and 86% for stone burden lesser and more than 2 cm2, respectively. The mean blood loss was 186ml for per operational case. Totally four patients (8.5%) underwent blood tranfusion. Conclusion: As a result, because of its high stone-free rates, the shorter hospital stay, minimal surgical scar and absence of wound infection, PNL is preserving its place for the treatment of stones bigger than 2 cm2. J Clin Exp Invest 2011; 2 (4): 371-374

References

  • Matlaga B R, Assimos D G: Changing indications of open stone surgery. Urology, 2002;59(4): 490-3.
  • Fernstrom I, Johanson B : Percutaneous pyelolıthotomy. Scand J Urol Nephrol 1976;10(3):257-9.
  • Tanrıverdi O, Boylu U, Kendirci M, Kadıhasanoğlu M, Horasanlı K, Miroğlu C. The learning curve in threatining of percutaneous nephrolithotomy. Eur Urol 2007;52(1):206-12.
  • Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gallucci M; Working Party on Lithiasis, European Association of Urology. Guidelines on urolithiasis. Eur Urol 2001; 40(4): 362-71.
  • Yalçın V, Önal B, Çitgez S, Çitçi Ş, Önder AU, Öner A. Üst kaliks girişi yapılan perkütan nefrolitotomi olgularında istenmeyen yan etki oranları ve sonuçlar. Türk Üroloji Dergisi 2007; 33(2): 196-201.
  • Wolf SJ, Clayman RV. Percutaneous nephros-tolithotomy: What is its role in 1997? Urol Clin North Am 1997;24(1):43-58.
  • Lee WJ, Smith AD, Cubelli V, Vernace FM. Percutaneous nephrolithotomy: analysis of 500 consecutive patients. Urol Radiol 1986;8(2):61-6.
  • Payne SR, Ford TF, Wickham JEA. Endoscopic management of upper urinary tract stones. Br J Surg1985;72(10):822-4.
  • Yalçın V, Önder U, Demirkesen O, Önal B, Kalkan M, Kural AR. Böbrek taşlarının tedavisinde perkütan nefrolitotomi. Türk Üroloji Dergisi 2002;28(2):194-200.
  • Ünsal A, Çimentepe E, Sağlam R. İlk 50 perkütan nefrolitotomi deneyimimiz. Türk Üroloji Dergisi 2002;28(4):422-7.
  • Walsh, Retik, Vaughan, Wein: Üriner taş hastalığının cerrahi tedavisi. Textbook of Campbell, pp 3416-51.
  • Lingeman JE, Coury TA, Newman DM, et al. Comparison of results and morbidity of percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy. J Urol1987;138(3):485-90.
  • Pearle MS, Clayman RV. Outcomes and selection of surgical therapies of stones in the kidney and ureter. In: Coe FL, Favus MJ, Pak CYC, Parks JH, Preminger GM (Eds). Kidney Stones: Medical and surgical management. Philadelphia; Lippincott Williams & Wilkins, 1995: pp 709-55
  • Snyder JA, Smith AD. Staghorn calculi; percutaneous extraction versus anathrophic nephrolithotomy. J Urol 1986; 136(2): 351-54.
  • Segura JW, Patterson DE, LeRoy AJ. Combined percutaneous ultrasonic lithotripsy and extra corporeal shock wave lithotripsy for struvite staghorn calculi. World J Urol 1987; 5(3): 245-47.
  • Assimos DG, Wrenn JJ, Harrison LH, et al. A comparison of anatrophic nephrolithotomy and percutaneous nephrolithotomy with and witout extracorporeal shock wave lithotripsy for management of patients with staghorn calculi. J Urol 1991; 145(4): 710-14.
  • Timoney AG, Payne SR, Walmsley BH, Vinnicombe J, Abercrombie GF. Partial nephrectomy: An option in calculus disease? Br J Urol1988; 62(6): 511-14.
  • Stening SG, Bourne S. Supracostal percutaneous nephrolithotomy for upper pole caliceal calculi. J Endourol 1998; 12(4): 359-62.
  • Golijanin D, Katz R, Verstandig A, Sasson T, Landau EH, Meretyk S. The supracostal percutaneous nephrostomy for treatment of staghorn and complex kidney stones. J Endourol 1998; 12(5): 403-5
  • Müslümanoğlu AY, Tefekli AH, Taş A, Çakır T, Sarılar Ö. Öğrenme eğrisinde ilk 100 perkütan nefrolitotomi olgusunun analizi. Türk Üroloji Dergisi 2004;30(3): 339-47.

Results of percutaneous nephrolithotomy performed in a regional state hospital

Year 2011, , 371 - 374, 01.12.2011
https://doi.org/10.5799/ahinjs.01.2011.04.0074

Abstract

Amaç: Bu çalışmanın amacı, bir devlet hastanesinde uygulanan böbrek taşı tedavisinde uygulanılan bir yöntem olan perkütan böbrek taşı cerrahisinin sonuçlarını değerlendirmektir. Gereç ve yöntem: Haziran 2010 ile Temmuz 2011 tarihleri arasında Batman Bölge Devlet Hastanesinde uygulanan 183 perkütan nefrolitotomi (PNL) vakasını retrospektif olarak değerlendirdik. Polikliniklerimize başvuran ve operasyon için uygun böbrek taşı tesbit edilen hastalara uygun laboratuar ve radyolojik incelemeler neticesinde PNL prosedürü uyguladık. Postoperatif dönemde radyolojik değerlendirmeler yapılarak rezidü taş olup olmadığını tesbit ettik. Rezidü taş (4 mm den büyük) varlığında Extracorporeal Schock Wawe Lithotripcy (ESWL), tekrar perkütan girişim veya takip protokollerini uyguladık. 6 hastamızda çeşitli sebeplerden dolayı açık operasyona geçildi. Bulgular: Böbrek taşı tanısıyla kliniğimizde PNL uygulanan 183 hastanın 81\'i kadın, 102\' si erkek olup, yaş ortalaması 37,6 (2-81) ve ortalama taş yükü 35,5 (15-80) mm2 olarak belirlendi. İşlem sonrası tespit edilen taşsızlık oranı %74.23 iken rezidü taş oranımız %25.77 idi. Operasyon öncesi taş yükü 2 cm2 den küçük hastalarda taşsızlık oranı %95 iken 2 cm2 ve üzerindeki taşlarda %86 idi. Kan kaybımız ortalama 192 ml idi. 14 (%8,5) hastaya kan transfüzyonu yapıldı. Sonuç: Sonuç olarak PNL tedavisi taş yükü 2 cm2 den büyük taşlarda yüksek taşsızlık oranı, kısa hastanede kalış süresi, cerrahi minimal yara izi ve yara enfeksiyonu olmaması sebebi ile taş cerrahi tedavisinde ilk sıradaki tercih sebebi olmaktadır.

References

  • Matlaga B R, Assimos D G: Changing indications of open stone surgery. Urology, 2002;59(4): 490-3.
  • Fernstrom I, Johanson B : Percutaneous pyelolıthotomy. Scand J Urol Nephrol 1976;10(3):257-9.
  • Tanrıverdi O, Boylu U, Kendirci M, Kadıhasanoğlu M, Horasanlı K, Miroğlu C. The learning curve in threatining of percutaneous nephrolithotomy. Eur Urol 2007;52(1):206-12.
  • Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gallucci M; Working Party on Lithiasis, European Association of Urology. Guidelines on urolithiasis. Eur Urol 2001; 40(4): 362-71.
  • Yalçın V, Önal B, Çitgez S, Çitçi Ş, Önder AU, Öner A. Üst kaliks girişi yapılan perkütan nefrolitotomi olgularında istenmeyen yan etki oranları ve sonuçlar. Türk Üroloji Dergisi 2007; 33(2): 196-201.
  • Wolf SJ, Clayman RV. Percutaneous nephros-tolithotomy: What is its role in 1997? Urol Clin North Am 1997;24(1):43-58.
  • Lee WJ, Smith AD, Cubelli V, Vernace FM. Percutaneous nephrolithotomy: analysis of 500 consecutive patients. Urol Radiol 1986;8(2):61-6.
  • Payne SR, Ford TF, Wickham JEA. Endoscopic management of upper urinary tract stones. Br J Surg1985;72(10):822-4.
  • Yalçın V, Önder U, Demirkesen O, Önal B, Kalkan M, Kural AR. Böbrek taşlarının tedavisinde perkütan nefrolitotomi. Türk Üroloji Dergisi 2002;28(2):194-200.
  • Ünsal A, Çimentepe E, Sağlam R. İlk 50 perkütan nefrolitotomi deneyimimiz. Türk Üroloji Dergisi 2002;28(4):422-7.
  • Walsh, Retik, Vaughan, Wein: Üriner taş hastalığının cerrahi tedavisi. Textbook of Campbell, pp 3416-51.
  • Lingeman JE, Coury TA, Newman DM, et al. Comparison of results and morbidity of percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy. J Urol1987;138(3):485-90.
  • Pearle MS, Clayman RV. Outcomes and selection of surgical therapies of stones in the kidney and ureter. In: Coe FL, Favus MJ, Pak CYC, Parks JH, Preminger GM (Eds). Kidney Stones: Medical and surgical management. Philadelphia; Lippincott Williams & Wilkins, 1995: pp 709-55
  • Snyder JA, Smith AD. Staghorn calculi; percutaneous extraction versus anathrophic nephrolithotomy. J Urol 1986; 136(2): 351-54.
  • Segura JW, Patterson DE, LeRoy AJ. Combined percutaneous ultrasonic lithotripsy and extra corporeal shock wave lithotripsy for struvite staghorn calculi. World J Urol 1987; 5(3): 245-47.
  • Assimos DG, Wrenn JJ, Harrison LH, et al. A comparison of anatrophic nephrolithotomy and percutaneous nephrolithotomy with and witout extracorporeal shock wave lithotripsy for management of patients with staghorn calculi. J Urol 1991; 145(4): 710-14.
  • Timoney AG, Payne SR, Walmsley BH, Vinnicombe J, Abercrombie GF. Partial nephrectomy: An option in calculus disease? Br J Urol1988; 62(6): 511-14.
  • Stening SG, Bourne S. Supracostal percutaneous nephrolithotomy for upper pole caliceal calculi. J Endourol 1998; 12(4): 359-62.
  • Golijanin D, Katz R, Verstandig A, Sasson T, Landau EH, Meretyk S. The supracostal percutaneous nephrostomy for treatment of staghorn and complex kidney stones. J Endourol 1998; 12(5): 403-5
  • Müslümanoğlu AY, Tefekli AH, Taş A, Çakır T, Sarılar Ö. Öğrenme eğrisinde ilk 100 perkütan nefrolitotomi olgusunun analizi. Türk Üroloji Dergisi 2004;30(3): 339-47.
There are 20 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Gökmen Akarer This is me

Alaadin Akay This is me

Zafer Akar This is me

Hasan Altaş This is me

Taner Çiftçi This is me

Publication Date December 1, 2011
Published in Issue Year 2011

Cite

APA Akarer, G., Akay, A., Akar, Z., Altaş, H., et al. (2011). Results of percutaneous nephrolithotomy performed in a regional state hospital. Journal of Clinical and Experimental Investigations, 2(4), 371-374. https://doi.org/10.5799/ahinjs.01.2011.04.0074
AMA Akarer G, Akay A, Akar Z, Altaş H, Çiftçi T. Results of percutaneous nephrolithotomy performed in a regional state hospital. J Clin Exp Invest. December 2011;2(4):371-374. doi:10.5799/ahinjs.01.2011.04.0074
Chicago Akarer, Gökmen, Alaadin Akay, Zafer Akar, Hasan Altaş, and Taner Çiftçi. “Results of Percutaneous Nephrolithotomy Performed in a Regional State Hospital”. Journal of Clinical and Experimental Investigations 2, no. 4 (December 2011): 371-74. https://doi.org/10.5799/ahinjs.01.2011.04.0074.
EndNote Akarer G, Akay A, Akar Z, Altaş H, Çiftçi T (December 1, 2011) Results of percutaneous nephrolithotomy performed in a regional state hospital. Journal of Clinical and Experimental Investigations 2 4 371–374.
IEEE G. Akarer, A. Akay, Z. Akar, H. Altaş, and T. Çiftçi, “Results of percutaneous nephrolithotomy performed in a regional state hospital”, J Clin Exp Invest, vol. 2, no. 4, pp. 371–374, 2011, doi: 10.5799/ahinjs.01.2011.04.0074.
ISNAD Akarer, Gökmen et al. “Results of Percutaneous Nephrolithotomy Performed in a Regional State Hospital”. Journal of Clinical and Experimental Investigations 2/4 (December 2011), 371-374. https://doi.org/10.5799/ahinjs.01.2011.04.0074.
JAMA Akarer G, Akay A, Akar Z, Altaş H, Çiftçi T. Results of percutaneous nephrolithotomy performed in a regional state hospital. J Clin Exp Invest. 2011;2:371–374.
MLA Akarer, Gökmen et al. “Results of Percutaneous Nephrolithotomy Performed in a Regional State Hospital”. Journal of Clinical and Experimental Investigations, vol. 2, no. 4, 2011, pp. 371-4, doi:10.5799/ahinjs.01.2011.04.0074.
Vancouver Akarer G, Akay A, Akar Z, Altaş H, Çiftçi T. Results of percutaneous nephrolithotomy performed in a regional state hospital. J Clin Exp Invest. 2011;2(4):371-4.