Distal Üreteral Taşların Üreterorenoskopik Tedavisinde Balon Dilatasyonunun Etkinlik Ve Güvenilirliğinin Değerlendirilmesi

Year 2020, Volume: 15 Issue: 2, 80 - 86, 12.06.2020

Mehmet Oğuz Şahin , Volkan Şen , Bora İrer , Güner Yıldız

https://doi.org/10.33719/yud.554713

Abstract

Amaç: Distal üreteral
taşların üreterorenoskopik tedavisinde balon dilatasyonunun etkinlik ve
güvenilirliğini değerlendirilmeyi amaçladık.

Gereç ve yöntemler: Distal üreter taşı nedeni ile Ocak
2007 – Haziran 2018 tarihleri arasında URS yapılan ardışık hastaların verileri
retrospektif olarak değerlendirildi. Hastalar balon dilatasyon ihtiyacına göre
2 gruba ayrıldı. Grup 1 balon dilatasyon (-) hastalardan; Grup 2 ise balon
dilatasyon (+) hastalardan oluşmaktaydı. Bu iki grup hastaların demografik
özellikleri, taş karakteristikleri, operasyon sonuçları ve komplikasyonları açısından
karşılaştırıldı.

Bulgular: Grup 1’de 359 (%70.4)
erkek, 151 (%29.6) kadın; grup 2’de ise 32
(%80.0) erkek ve 8 (%20.0) kadın hasta bulunmaktaydı (p=0.197). Grup 1 için yaş
ortalaması 43.3±14.3 yıl iken, grup 2 için 44.2±14.9
yıl olarak hesaplandı ve gruplar arası fark yoktu
(p=0.704). Ameliyat süresi balon dilatasyon grubunda daha uzun idi (grup
1’de 32.8±20.5 dk ve grup 2’de 40.1±16.0
dk; p=0.029). Postoperatif taşsızlık oranı grup 1’de anlamlı şekilde daha
yüksek olmasına rağmen (%98.6 vs %90.0; p=0.017), komplikasyon oranları gruplar
arasında benzer olarak saptandı (%3.2 vs
%2.5; p=0.787).

Sonuç: Distal üreter taşı tedavisi amaçlı yapılan
üreterorenoskopide üreter darlıkları için eş zamanlı balon dilatasyonu
uygulaması, güvenli ve maliyetleri azaltan bir yöntemdir. Operasyon süresinde
bir miktar uzama ve taşsızlık oranlarındaki düşmeye rağmen, komplikasyon
oranlarını etkilememektedir ve aynı taş için yeni operasyondan hastayı
korumaktadır. Bu işlemin uzun dönem sonuçları için prospektif ve randomize çalışmalara
ihtiyaç duyulmaktadır. 

Keywords

üreter balon dilatasyon , üreter taşı , üreter taş tedavisi , üreteroskopi

Evaluation Of Efficacy And Safety Of Balloon Dilatation İn Ureterorenoscopy For The Treatment Of Distal Ureteral Stones

Abstract

Objective: We aimed to
evaluate the efficacy and safety of balloon dilatation in ureterorenoscopy for
the treatment of distal ureteral stones.

Materials
and Methods: The retrospective data of patients who underwent
URS for distal ureter stones between January 2008 and June 2018 were evaluated.
Patients were divided into two groups according the need of balloon dilatation.
Group 1 was consisted of balloon dilatation (-) patients and Group 2 was
cosnsited of balloon dilatation (+) patients. These two groups were compared in
terms of demographic of patients, stone characteristics, operation outcomes and
complications.

Results: Group
1 was consisted of 359 (70.4%) male and 151 (29.6%) female; group 2 was
consisted of 32 (80%) male and 8 (20%) female patients (p=0.197).
The mean age of patients was  43.3±14.3
years in group 1  and  44.2±14.9 years in group 2 (p=0.704).
Operation time was significantly higher in group 2 (32.8±20.5 min vs  40.1±16.0; p=0.029). Although stone free rate
was significantly higher in group 1 (%98.6 vs %90.0; p=0.017); the complication
rate was similar between groups (%3.2 vs %2.5; p=0.787).

Conclusions: The same session balloon dilatation for ureteral
structures in ureterorenoscopy for the treatment of distal ureteral stones
seems safe and cost-effective method. Although
this procedure may lead to elongation in operation times and decrease the stone
free rates; it does not affect the complication rates and prevents patients
from needing a new operation for same stone. Further randomized and prospective studies are needed for long
term outcomes of this procedure.

Keywords

ureteral balloon dilatation , ureteral stone , ureteral stone treatment , ureteroscopy

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