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Atnalı Böbreklerde Perkütan Nefrolitotomi Deneyimlerimiz

Year 2019, , 464 - 469, 16.09.2019
https://doi.org/10.31832/smj.538899

Abstract

Giriş

Atnalı böbrek,
renal füzyon anomalilerinin en yaygın görülen tipidir. En sık görülen
komplikasyonu ise böbrek taşlardır. Bu çalışmanın amacı, atnalı böbrek
anomalisi olan hastalarda, renal taşların tedavisinde uygulanan perkütan
nefrolitotomi (PNL) cerrahisinin sonuçlarını değerlendirmektir.

Gereç ve Yöntemler

Çalışmaya
kliniğimizde 2014 ile 2018 yılları arasında, atnalı böbreğinde taş bulunan ve
PNL yapılan yedi hasta dahil edildi. Hastaların yaş (yıl), cinsiyet, taş
özellikleri (taş yüzey alanı, taraf ve lokalizasyon), operasyon süresi (dk),
floroskopi süresi (dk), hemoglobin değişim miktarı, Hounsfield Ünitesi (HU)
değerleri,
nefrostomi alınma zamanı (gün), komplikasyonları
ve rezidüel taşları değerlendirildi. Tüm hastalar için PNL genel anestezi
altında prone pozisyonda gerçekleştirildi. Postoperatif 1. ayda, kontrastsız
bilgisayarlı tomografi ile hastalar kontrol edildi. 4 mm'den büyük taşlar rezidü
taş olarak kabul edildi.

Bulgular

Hastaların yaş
ortalaması
50,50±2,12 (48-69) yıl idi ve hepsi
erkekti. Ortalama taş yüzey alanı ve HU değerleri sırasıyla 441,50±156,20
mm2
ve 1317,50±123,70 olarak bulunmuştur. PNL yapılan hastaların ikisinde
başarısız
ekstrakorporeal şok dalga litotripsi (ext­racorporeal shock wave lithotripsy =ESWL) öyküsü vardı. Ameliyat sırasında veya postoperatif
dönemde hiçbir hastada majör komplikasyon gelişmedi. Toplam rezidü taş oranı 42,80% (3/7).

Sonuç















Bizim sonuçlarımıza
göre, PNL operasyonu atnalı böbreklerde güvenli ve etkili bir şekilde
uygulanabilir. 

References

  • 1. Weizer AZ, Silverstein AD, Auge BK, Delvecchio FC, Raj G, Albala DM, et al. Determining the incidence of horseshoe kidney from radiographic data at a single institution. J Urol 2003;170(5):1722-1726.
  • 2. Bauer S. Anomalies of the upper urinary tract. In: Walsh PC, Retic AB, Vaughan ED, et al. ed. Campbell’s Urology, 8th ed. Philadelphia: Elsevier Saunders. 2002. s:1885-1913.
  • 3. Yohannes P, Smith AD. The endourological management of complications associated with horseshoe kidney. J Urol 2002;168:5–8.
  • 4. Ongeti, K. W, Ogeng’o, J, Saidi, H. A horseshoe kidney with partial duplex systems. Int J Anat Var 2011;4:55-56.
  • 5. Cussenot O, Desgrandchamps F, Ollier P, Teillac P, Le Duc A. Anatomical bases of percutaneous surgery for calculi in horseshoe kidney. Surg Radiol Anat 1992;14(3):209–213.
  • 6. Lampel A, Hohenfellner M, Schultz-Lampel D, Lazica M, Bohnen K, Thürof JW. Urolithiasis in horseshoe kidneys: Therapeutic management. Urology 1996;47(2):182–186.
  • 7. Kirkali Z, Esen AA, Mungan MU. Effectiveness of extracorporeal shockwave lithotripsy in the management of stone-bearing horseshoe kidneys. J Endourol 1996;10(1):13-15.
  • 8. Ray AA, Ghiculete D, D’A Honey RJ, Pace KT. Shockwave lithotripsy in patients with horseshoe kidney: determinants of success. J Endourl 2011;25(3):487-493.
  • 9. Sheir, K.Z., K. Madbouly, E. Elsobky, Abdelkhalek M. Extracorporeal shock wave lithotripsy in anomalous kidneys: 11-year experience with two second-generation lithotripters. Urology 2003;62(1):10-15.
  • 10. Atis G, Resorlu B, Gurbuz C, Arikan O, Ozyuvali E, Unsal A, et al. Retrograde intrarenal surgery in patients with horseshoe kidneys. Urolithiasis 2013;41(1):79-83.
  • 11. Molimard B, Al-Qahtani S, Lakmichi A, Sejiny M, Gil-Diez de Medina S, Carpentier X, et al. Flexible ureterorenoscopy with holmium laser in horseshoe kidneys. Urology 2010;76(6):1334-1337.
  • 12. Chouaib A, Al-Qahtani S, Thoma A, Cordier G, Merlet B, Gil-Diez S, et al. Horseshoe kidney stones: benefit of flexible ureterorenoscopy with holmium laser. Prog Urol 2011;21(2):109-113.
  • 13. Miller NL, Matlaga BR, Handa SE, Munch LC, Lingeman JE. The presence of horseshoe kidney does not affect the outcome of percutaneous nephrolithotomy. J Endourol 2008;22:1219-1225.
  • 14. Janetschek G, Kunzel KH. Percutaneous nephroli¬thotomy in horseshoe kidneys. Applied anatomy and clinical experience. Br J Urol 1988;62:117-122.
  • 15. Shokeir AA, El-Nahas AR, Shoma AM, Eraky I, El-Kenawy M, Mokhtar A, et al. Percutaneous nephrolithotomy in treatment of large stones within horseshoe kidneys. Urology 2004;64(3):426-429.
  • 16. Symons SJ, Ramachandran A, Kurien A, Baiysha R, Desai MR.. Urolithiasis in the horseshoe kidney: a single-centre experience. BJU Int. 2008;102:1676-1680.
  • 17. Satav V, Sabale V, Pramanik P, Kanklia SP, Mhaske S. Percutaneous nephrolithotomy of horseshoe kidney: Our institutional experience. Urol Ann. 2018;10(3):258-262.
  • 18. Kyriazis I, Panagopoulos V, Kallidonis P, Özsoy M, Vasilas M, Liatsikos E. Complications in percutaneous nephrolithotomy. World J Urol 2015;33(8):1069-1077.
  • 19. Raj GV, Auge BK, Weizer AZ, et al. Percutaneous management of calculi within horseshoe kidneys. J Urol 2003;170:48–51.
  • 20. Liatsikos EN, Kallidonis P, Stolzenburg JU, Ost M, Keeley F, Traxer, et al. Percutaneous management of staghorn calculi in horseshoe kidneys: a multiinstitutional experience. J Endourol 2010;24:531–536.
  • 21. El-Nahas AR, Shokeir AA, El-Assmy AM, Shoma AM, Eraky I, El-Kenawy MR, et al. Colonic perforation during percutaneous nephrolithotomy: study of risk factors. Urology 2006;67(5):937-941.
Year 2019, , 464 - 469, 16.09.2019
https://doi.org/10.31832/smj.538899

Abstract

References

  • 1. Weizer AZ, Silverstein AD, Auge BK, Delvecchio FC, Raj G, Albala DM, et al. Determining the incidence of horseshoe kidney from radiographic data at a single institution. J Urol 2003;170(5):1722-1726.
  • 2. Bauer S. Anomalies of the upper urinary tract. In: Walsh PC, Retic AB, Vaughan ED, et al. ed. Campbell’s Urology, 8th ed. Philadelphia: Elsevier Saunders. 2002. s:1885-1913.
  • 3. Yohannes P, Smith AD. The endourological management of complications associated with horseshoe kidney. J Urol 2002;168:5–8.
  • 4. Ongeti, K. W, Ogeng’o, J, Saidi, H. A horseshoe kidney with partial duplex systems. Int J Anat Var 2011;4:55-56.
  • 5. Cussenot O, Desgrandchamps F, Ollier P, Teillac P, Le Duc A. Anatomical bases of percutaneous surgery for calculi in horseshoe kidney. Surg Radiol Anat 1992;14(3):209–213.
  • 6. Lampel A, Hohenfellner M, Schultz-Lampel D, Lazica M, Bohnen K, Thürof JW. Urolithiasis in horseshoe kidneys: Therapeutic management. Urology 1996;47(2):182–186.
  • 7. Kirkali Z, Esen AA, Mungan MU. Effectiveness of extracorporeal shockwave lithotripsy in the management of stone-bearing horseshoe kidneys. J Endourol 1996;10(1):13-15.
  • 8. Ray AA, Ghiculete D, D’A Honey RJ, Pace KT. Shockwave lithotripsy in patients with horseshoe kidney: determinants of success. J Endourl 2011;25(3):487-493.
  • 9. Sheir, K.Z., K. Madbouly, E. Elsobky, Abdelkhalek M. Extracorporeal shock wave lithotripsy in anomalous kidneys: 11-year experience with two second-generation lithotripters. Urology 2003;62(1):10-15.
  • 10. Atis G, Resorlu B, Gurbuz C, Arikan O, Ozyuvali E, Unsal A, et al. Retrograde intrarenal surgery in patients with horseshoe kidneys. Urolithiasis 2013;41(1):79-83.
  • 11. Molimard B, Al-Qahtani S, Lakmichi A, Sejiny M, Gil-Diez de Medina S, Carpentier X, et al. Flexible ureterorenoscopy with holmium laser in horseshoe kidneys. Urology 2010;76(6):1334-1337.
  • 12. Chouaib A, Al-Qahtani S, Thoma A, Cordier G, Merlet B, Gil-Diez S, et al. Horseshoe kidney stones: benefit of flexible ureterorenoscopy with holmium laser. Prog Urol 2011;21(2):109-113.
  • 13. Miller NL, Matlaga BR, Handa SE, Munch LC, Lingeman JE. The presence of horseshoe kidney does not affect the outcome of percutaneous nephrolithotomy. J Endourol 2008;22:1219-1225.
  • 14. Janetschek G, Kunzel KH. Percutaneous nephroli¬thotomy in horseshoe kidneys. Applied anatomy and clinical experience. Br J Urol 1988;62:117-122.
  • 15. Shokeir AA, El-Nahas AR, Shoma AM, Eraky I, El-Kenawy M, Mokhtar A, et al. Percutaneous nephrolithotomy in treatment of large stones within horseshoe kidneys. Urology 2004;64(3):426-429.
  • 16. Symons SJ, Ramachandran A, Kurien A, Baiysha R, Desai MR.. Urolithiasis in the horseshoe kidney: a single-centre experience. BJU Int. 2008;102:1676-1680.
  • 17. Satav V, Sabale V, Pramanik P, Kanklia SP, Mhaske S. Percutaneous nephrolithotomy of horseshoe kidney: Our institutional experience. Urol Ann. 2018;10(3):258-262.
  • 18. Kyriazis I, Panagopoulos V, Kallidonis P, Özsoy M, Vasilas M, Liatsikos E. Complications in percutaneous nephrolithotomy. World J Urol 2015;33(8):1069-1077.
  • 19. Raj GV, Auge BK, Weizer AZ, et al. Percutaneous management of calculi within horseshoe kidneys. J Urol 2003;170:48–51.
  • 20. Liatsikos EN, Kallidonis P, Stolzenburg JU, Ost M, Keeley F, Traxer, et al. Percutaneous management of staghorn calculi in horseshoe kidneys: a multiinstitutional experience. J Endourol 2010;24:531–536.
  • 21. El-Nahas AR, Shokeir AA, El-Assmy AM, Shoma AM, Eraky I, El-Kenawy MR, et al. Colonic perforation during percutaneous nephrolithotomy: study of risk factors. Urology 2006;67(5):937-941.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Hüseyin Aydemir 0000-0003-4048-7311

Salih Budak This is me

Fikret Halis

Deniz Gül

Hacı İbrahim Çimen

Osman Köse This is me

Hasan Salih Sağlam This is me

Ahmet Gökçe This is me

Publication Date September 16, 2019
Submission Date March 12, 2019
Published in Issue Year 2019

Cite

AMA Aydemir H, Budak S, Halis F, Gül D, Çimen Hİ, Köse O, Sağlam HS, Gökçe A. Atnalı Böbreklerde Perkütan Nefrolitotomi Deneyimlerimiz. Sakarya Tıp Dergisi. September 2019;9(3):464-469. doi:10.31832/smj.538899

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