Robot yardımlı transperitoneal piyeloplasti sonuçları: Vaka serisi

Year 2019, , 870 - 872, 03.12.2019

İbrahim Karabulut , Ali Haydar Yılmaz , Fatih Kürşat Yılmazel , Fatih Özkaya

https://doi.org/10.28982/josam.638664

Abstract

Amaç: Üretero pelvik bileşke (ÜPB) darlıkları idrarın renal pelvisten üretere geçişini kısıtlayan ve gerekli durumlarda tedavi edilmezse kademeli olarak böbrek fonksiyonlarında kayıba yol açabilen bir durum olarak kabul edilir. ÜPB darlıklarını dıştan başı yada iç tıkanıklığa bağlı olabilir. Semptomatik ÜPB darlıkları tedavi edilmelidir. Biz bu çalışmamızda kliniğimizde robot yardımlı piyeloplasti (RYP) yaptığımız hastaların sonuçlarını sunmayı amaçladık.

Yöntemler: Kliniğimizde Ocak 2017 - 2019 tarihleri arasında RYP yaptığımız 15 hastanın verileri incelendi. Üretero pelvik bileşke darlığı (UPBD) tanısı, intravenöz piyelografi (IVP) ve diürez renografisi (DTPA) ile hasta muayenesi veya olası kontrolleri takiben yapıldı. Da Vinci XI 4 kollu robotik sistem kullanan tüm hastalara dismembred piyeloplasti yapıldı. Sonuçlar retrospektif olarak değerlendirildi.

Bulgular: Hastaların yaş ortalaması 41,3 (8,2) idi. Cinsiyet dağılımı 7 erkek, 8 kadındı. Tüm işlemler birincil olgularda yapıldı. Hastaların 6' sında intrinsik obstrüksiyon, 9' unda dıştan dammar basısına bağlı ekstrinsik obstrüksiyon vardı. Ortalama ameliyat süresi 155,3 (29,8) dakika idi. Ortalama anastomoz süresi 33,4 (8,1) dakika idi. İntraoperatif kanama miktarı 48 (10.2) cc olarak bulundu. Ortalama hastanede kalış süresi 3,6 (1,1) gündü. Hiçbir hastada açık cerrahi müdahale olmadı. Hiçbir hastada intraoperatif veya postoperatif komplikasyon gözlenmedi. Ortalama takip süresi 12,7 (5,4) aydı. Postoperatif IVP ve DTPA tüm hastaların düzeldiği tespit edildi.

Sonuç: Çalışmamızda tespit edildiği gibi, RYP UPBD tedavisinde başarılı cerrahi ve fonksiyonel sonuçları olan minimal bir invaziv yöntemdir.

Keywords

Robotik Cerrahi, Üreteropelvik obstrüksiyon, Piyeloplasti

Outcomes of robot-assisted transperitoneal pyeloplasty: Case series

Abstract

Aim: Ureteral pelvic junction (UPJ) obstruction, which restricts the passage of urine from the pelvis to the ureter may cause progressive destruction of the kidney if left untreated. Causes of UPJ obstruction include various intrinsic and extrinsic factors. Symptomatic UPJ obstruction should be treated without delay. We herein aimed to present the results of robot-assisted pyeloplasty (RAP) that we performed in our clinic.

Methods: Data of 15 patients who underwent RAP between January 2017 and 2019 in our clinic were examined. The diagnosis of ureteropelvic junction obstruction (UPJO) was based on intravenous pyelography (IVP), and diuresis renography (DTPA) was performed during follow-up. Dismembered pyeloplasty was performed on all patients with the DaVinci XI 4-arm robotic system. The results were retrospectively evaluated. 

Results: The mean age of all patients was 41.3 (8.2) years. There were 7 males and 8 females. None of the cases had previously undergone pyeloplasty. While 6 of the patients had intrinsic obstruction, 9 had extrinsic obstruction associated with aberrant vascular compression. The mean operation time and duration of anastomosis were 155.3 (29.8) and 33.4 (8.1) minutes, respectively. The mean amount of intraoperative bleeding was 48 (10.2) ml. The mean hospital stay was found as 3.6 (1.1) days. There was no conversion to open surgery in any of the patients. None of the patients had intraoperative or postoperative complications. The mean follow-up time was 12.7 (5.4) months. Postoperative IVP and DTPA of all the patients were found to have improved.

Conclusion: RAP is a minimally invasive method with successful surgical and functional outcomes in the treatment of UPJO.

Keywords

Robotic Surgery, Ureteropelvic obstruction, Pyeloplasty

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