TY - JOUR T1 - Can the Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio Be Used to Predict the Risk of Ureteral Stricture Following Ureteroscopy? TT - Üreteroskopi Sonrası Üreter Darlığı Gelişme Riskini Öngörmede Nötrofil/Lenfosit Oranı ve Platelet/Lenfosit Oranı Kullanılabilir Mi? AU - Akdeniz, Ekrem AU - Ordulu, Reha AU - Aydın, Mustafa AU - Küçük, Emrah AU - Yıldız, Hakan AU - Ulubay, Mahmut AU - Atilla, Mustafa Kemal PY - 2024 DA - September Y2 - 2024 DO - 10.54233/endourolbull-1526700 JF - Endoüroloji Bülteni JO - Endourol Bull PB - Endoüroloji Derneği WT - DergiPark SN - 2148-0532 SP - 99 EP - 107 VL - 16 IS - 3 LA - en AB - Objective: The purpose of this study was to investigate whether the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) can be used to predict the development of ureteral stricture or difficult ureter in patients who had previously undergone endoscopic upper urinary tract surgery.Material and Methods: This observational study was performed between April 2022 and April 2023 at the Samsun Training and Research Hospital Urology Department, Türkiye. One hundred thirty patients who had undergone prior endoscopic upper urinary tract surgery were included. These were divided into two groups, with (Group 1) and without (Group 2) ureteral stricture. The diagnosis of ureteral stricture was based on direct endoscopy or retrograde pyelography. The groups’ sociodemographic characteristics, clinical data, and NLR and PLR values were then compared.Results: The patients’ mean ages were 49.89±14.40 years in Group 1 and 48.92±14.60 in Group 2 (p = 0.704). No statistically significant differences were observed between the groups in terms of sex, body mass index, or comorbidity. However, significant differences were determined in terms of passage of kidney stones and numbers of surgical procedures performed (p = 0.001 and p KW - Ureter stenosis KW - difficult/ stringent ureter KW - neutrophil-lymphocyte ratio KW - platelet-lymphocyte ratio N2 - Amaç: Bu çalışmanın amacı daha önce endoskopik üst üriner sistem cerrahisi geçiren hastalarda üreter darlığı veya zor/sıkı üreter gelişim riskini öngörmede, nötrofil/lenfosit oranı (NLO) ve platelet/lenfosit oranı (PLO)’nın etkinliğini araştırmaktır.Gereç ve Yöntemler: Bu gözlemsel çalışma Nisan 2022 ile Nisan 2023 tarihleri arasında Samsun Eğitim ve Araştırma Hastanesi, Üroloji Kliniği’nde yapılmıştır. Çalışmaya daha önce endoskopik üst üriner sistem cerrahisi geçiren 130 hasta alınmıştır. Hastalar üreter darlığı olanlar (Grup 1) ve olmayanlar (Grup 2) olmak üzere iki gruba ayrılmıştır. Üreter darlığı direk endoskopik olarak veya retrograd piyelografi ile konulmuştur. Grupların sosyodemografik özellikleri, klinik verileri, NLO ve PLO değerleri karşılaştırılmıştır.Bulgular: Çalışmaya alınan hastaların yaş ortalaması Grup 1’de 49,89 ± 14,40 ve Grup 2’de 48,92 ± 14,60 yıl olarak bulundu (p = 0,704). Vücut kitle indeksi, cinsiyet, hidronefroz, komordite açısından gruplar arasında istatistiksel olarak fark izlenmezken; taş düşürme öyküsü ve geçirilmiş operasyon sayısı açısından anlamlı fark izlendi (sırasıyla p = 0,001 ve p CR - 1. D’Addessi A, Bassi P. Ureterorenoscopy: avoiding and managing the complications. Urol Int. 2011;87(3):251-9. https://doi.org/10.1159/000329286 CR - 2. Degirmenci T, Gunlusoy B, Kozacioglu Z, et al. Outcomes of ureteroscopy for the management of impacted ureteral calculi with different localizations. Urology. 2012;80(4):811-5. https://doi.org/10.1016/j.urology.2012.05.007 CR - 3. El-Abd AS, Suliman MG, Abo Farha MO, et al. The development of ureteric strictures after ureteroscopic treatment for ureteric calculi: A long-term study at two academic centres. Arab J Urol. 2014;12(2):168-72. https://doi.org/10.1016/j.aju.2013.11.004 CR - 4. Nakada SY, Soble JJ, Gardner SM, et al. Comparison of acucise endopyelotomy and endoballoon rupture for management of secondary proximal ureteral stricture in the porcine model. J Endourol. 1996;10(4):311-8. https://doi.org/10.1089/end.1996.10.311 CR - 5. Cetti RJ, Biers S, Keoghane SR. The difficult ureter: what is the incidence of pre-stenting? Ann R Coll Surg Engl. 2011;93(1):31-3. https://doi.org/10.1308/003588411X12851639106990 CR - 6. Söylemez H, Yıldırım K, Utangac MM, Aydoğan TB, Ezer M, Atar M. A New Alternative for Difficult Ureter in Adult Patients: No Need to Dilate Ureter via a Balloon or a Stent with the Aid of 4.5F Semirigid Ureteroscope. J Endourol. 2016;30(6):650-4. https://doi.org/10.1089/end.2016.0118 CR - 7. Baetta R, Corsini A. Role of polymorphonuclear neutrophils in atherosclerosis: current state and futureperspectives. Atherosclerosis. 2010;210(1):1-13. https://doi.org/10.1016/j.atherosclerosis.2009.10.028 CR - 8. Balta S, Aparcı M, Ozturk C, Demirkol S, Celik T. Neutrophil-lymphocyte ratio as an useful mortality marker. Am J Emerg Med. 2014;32(12):1546-7. https://doi.org/10.1016/j.ajem.2014.09.040 CR - 9. Timberlake MD, Herndon CD. Mild to moderate postnatal hydronephrosis--grading systems and management. Nat Rev Urol. 2013;10(11):649-56. https://doi.org/10.1038/nrurol.2013.172 CR - 10. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-13. https://doi.org/10.1097/01.sla.0000133083.54934.ae CR - 11. Perez Castro E, Osther PJ, Jinga V, et al. Differences in ureteroscopic stone treatment and outcomes for distal, mid- , proximal, or multiple ureteral locations: the Clinical Research Office of the Endourological Society ureteroscopy global study. Eur Urol. 2014;66(1):102-9. https://doi.org/10.1016/j.eururo.2014.01.011 CR - 12. Ekici O, Gul A, Zengin S, Boyaci C, Kilic M. The Impact of Ureteral Wall Thickness on Spontaneous Passage and Development of Long-term Ureteral Stricture in Patients with Ureteral Stone. J Coll Physicians Surg Pak. 2023;33(1):97-102. https://doi.org/10.29271/jcpsp.2023.01.97 CR - 13. Moretto S, Saita A, Scoffone CM, et al. Ureteral stricture rate after endoscopic treatments for urolithiasis and related risk factors: systematic review and meta-analysis. World J Urol. 2024;42(1):234. https://doi.org/10.1007/s00345-024-04933-2 CR - 14. Tan J, Yu Z, Ling X, et al. Main Pathological Changes of Benign Ureteral Strictures. Front Med (Lausanne). 2022;9:916145. https://doi.org/10.3389/fmed.2022.916145 CR - 15. Lee KS, Ha JS, Koo KC. Significance of Neutrophil-to-Lymphocyte Ratio as a Novel Indicator of Spontaneous Ureter Stone Passage. Yonsei Med J. 2017;58(5):988-93. https://doi.org/10.3349/ymj.2017.58.5.988 CR - 16. Abou Heidar N, Labban M, Bustros G, Nasr R. Inflammatory serum markers predicting spontaneous ureteral stone passage. Clin Exp Nephrol. 2020;24(3):277-83. https://doi.org/10.1007/s10157-019-01807-5 CR - 17. Jain A, Sreenivasan SK, Manikandan R, Dorairajan LN, Sistla S, Adithan S. Association of spontaneous expulsion with C-reactive protein and other clinico-demographic factors in patients with lower ureteric stone. Urolithiasis. 2020;48(2):117-22. https://doi.org/10.1007/s00240-019-01137-x CR - 18. Elsaraya N, Gordon-Irshai A, Schwarzfuchs D, Novack V, Mabjeesh NJ, Neulander EZ. Neutrophil to lymphocyte ratio as an early indicator for ureteral catheterization in patients with renal colic due to upper urinary tract lithiasis. PLoS One. 2022;17(6):e0270706. https://doi.org/10.1371/journal.pone.0270706 CR - 19. Yavuzsan AH, Kirecci SL, Ilgi M, et al. Failure of ureteral access sheath insertion in primary flexible ureteroscopy for renal stones: is there any relation with inflammation? Aktuelle Urol. 2022;53(1):67-74. https://doi.org/10.1055/a-1378-2495 UR - https://doi.org/10.54233/endourolbull-1526700 L1 - http://dergipark.org.tr/tr/download/article-file/4115953 ER -