Endoskopik Taş Tedavisinde Gelecekte Bizleri Ne Bekliyor?

Yıl 2020, Cilt: 12 Sayı: 2, 157 - 162, 23.07.2020

Fatih Sandıkçı Burhan Baylan Abdurrahim İmamoğlu

Öz

Son yıllarda; yaşlı popülasyonun
artışı, artan obezite oranı, kötü beslenme alışkanlıkları, yetersiz sıvı alımı,
sedanter yaşam tarzı gibi nedenler üriner sistem taş hastalığı insidansını da
artırmaktadır (1).  Artan insidans
karşısında taş cerrahisi de operasyon teknikleri ve teknolojik ilerlemeler eşliğinde
gelişimini sürdürmektedir. Son 30 yıldaki teknolojik gelişmeler, üriner sistem
taş hastalığının tedavisinde devrim oluşturmuştur.

Geçmişte, üriner sistem taş
hastalıkları açık cerrahi yöntem ile tedavi edilirken, 1980’lerde
ekstrakorporeal şok dalga litotripsi (ESWL) popülarize olmuş, sonraki yıllarda
Perkütan Nefrolitotripsi tedavileriı gündemde yerini almıştır. Fleksibl
üreteroskopinin (URS) kullanımı ve laser teknolojisindeki ilerlemeler sayesinde
retrograd böbrek içi cerrahinin (RIRS) uygulanma sıklığı artmıştır. Avrupa
Üroloji Kılavuzu’na baktığımızda 2 cm ve üzeri böbrek taşlarının tedavisinde
perkütan nefrolitotomi (PNL) tercih edilmektedir. İki cm altındaki taşlarda ise
taşın yerine ve kaliks yapısına tedaviye karar verilmektedir. Hasta pozisyonu,
giriş teknikleri, mini perkütan yöntemleri, PNL-RIRS kombinasyonu, taşın 3
boyutlu demostrasyonu gibi alt başlıklardaki gelişmeler, gelecekte bizleri bu
konuda nelerin beklediğini bugünlerden tahmin etmemizi sağlayabilir.

Bu derlemede, endoskopik tedavi
yöntemleriyle taş hastalığının güncel tedavileri, bu tedavi yöntemlerinin
geleceği ve teknolojik yeniliklerin anlatılması amaçlanmıştır.

Anahtar Kelimeler

endoskopik, endoüroloji, gelecek, laser, taş, yenilikler

What does expect us in endoscopic stone treatment in the future?

Öz

In recent years; reasons such as increased elderly population, increased obesity rate, poor eating habits, inadequate fluid intake, sedentary lifestyle also increases the incidence of urinary stone disease. In the face of increasing incidence, stone surgery continues its development, accompanied by operational techniques and technological advances. Technological advances in the last 30 years have revolutionized the treatment of urinary system stone disease. In the past, urinary stone diseases were treated with open surgery; in the 1980s, extracorporeal shock wave lithotripsy (SWL) became popular; in the following years, Percutaneous Nephrolithotomy (PNL) treatments have been on the agenda. With the use of flexible ureteroscopy (URS) and advances in lazer technology, the frequency of retrograde renal surgery (RIRS) has increased. According to the European Urology Guide; PNL is preferred for the treatment of renal stones of 2 cm or more. For stones smaller than 2 cm, treatment is decided according to the location of the stone and the calyceal structure. Advances in subheadings such as patient position, entry techniques, mini-percutaneous methods, PNL-RIRS combination and 3D demonstrations; It may provide us to predict what will be expected of us in the future from now. In this review; it is aimed to explain current treatment of stone disease with endoscopic treatment methods, the future of these treatment methods and technological innovations.

Anahtar Kelimeler

endoscopic, endourology, future, lazer, stone, innovations

Kaynakça

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