Üretra Darlığında Endoskopik Cerrahi: Bıçağa Karşı Lazer

Year 2020, Volume: 15 Issue: 1, 39 - 44, 26.02.2020

Mehmet Solakhan , Ömer Bayrak

https://doi.org/10.33719/yud.590392

Abstract

Amaç:
Üretra darlığının endoskopik cerrahisinde cold knife üretrotomi
ile laser üretrotominin etkinliğini karşılaştırmayı amaçladık.

Materyal-metod:
Toplam
171 hasta retrospektif olarak değerlerlendirildi. Çalışma
kapsamında verileri tam olan 118 hasta 2 gruba ayrıldı (grup 1;
n=53 cold knife üretrotomi, grup 2; n= 65 lazer üretrotomi).
Darlığın uzunluğu, operasyon süresi, preoperatif ve
postoperatif 3., 6. ve12. aylardaki Qmax değerleri, nüks olup
olmadığı ve komplikasyon varlığı (kanama, extravazasyon, ateş
gb) açısından iki grup karşılaştırıldı.

Bulgular:
Operasyon zamanının cold knife üretrotomi yapılan hastalarda daha
kısa olduğu görüldü (14.01 ± 3.86 dk vs 25.03 ± 4.43 dk,
p=0.001). Postoperatif 3., 6., ve 12. aylardaki Q max değerlerinin
lazer üretrotomi yapılan hastalarda daha yüksek olduğu görüldü
(p=0.03, p=0.001, p=0.001). Bir yıllık takip sonucunda grup-1' de
28 (52.83%) hastada nüks saptanırken, grup-2' de 12 (18.46%)
hastada nüks geliştiği gözlendi (p=0.01). Postoperatif
komplikasyonlar açısından her iki grup arasında istatiksel olarak
anlamlı fark izlenmedi. (p=0.209).

Sonuç:
Yaptığımız
bu çalışmada üretra darlığını endoskopik cerrahisinde, lazer
üretrotomi tekniğinin, cold
knife üretrotomiye göre yüksek Qmax değerlerine ve daha düşük
nüks oranına sahip olması nedeniyle daha başarılı bir cerrahi
yöntem olduğu saptanmıştır. Sonuçların prospektif, randomize
çalışmalarla desteklenmesi gerekmektedir. 

Keywords

üretral darlık , lazer üretrotomi , soğuk bıçak , nüks

Endoscopic Surgery of Urethral Strictures: Laser Versus Knife

Abstract

Aims:
We aimed to compare the efficiency of cold knife urethrotomy and
laser urethrotomy in endoscopic surgery of urethral strictures.

Material-Methods:
A total of 171 patients were evaluated retrospectively. A 118
patients with complete data were divided into two groups (group 1; n
= 53 cold knife urethrotomy, group 2; n = 65 laser urethrotomy) in
the study. Length of the stricture, operation time, preoperative and
postoperative 3rd,
6th
and 12th-month
Qmax values, recurrence and the presence of complications (such as
bleeding, extravasation, fever etc.) were compared in terms of the
two groups.

Results:
The operation time was found to be shorter in patients who underwent
cold knife urethrotomy (14.01 ± 3.86 min vs 25.03 ± 4.43 min,
p=0.001). The Q max values at the postoperative 3rd,
6th
and 12th
months were observed to be higher in patients who underwent laser
urethrotomy (p=0.03, p=0.001, p=0.001). At the end of a one-year
follow-up, recurrence was determined in 28 (52.83%) patients in group
1 and 12 (18.46%) patients had a recurrence
in group 2 (p=0.01). No
statistically significant difference was observed between the two
groups in terms of postoperative complications.
(p=0.209).

Conclusions:
In this study, it was determined that laser urethrotomy technique was
a more successful surgical method than cold knife urethrotomy in the
endoscopic surgery of urethral strictures as it has higher Qmax
values and lower recurrence rate. The results should be supported by
prospective, randomized studies. 

Keywords

urethral stricture , laser urethrotomy , cold knife , nux

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