Our experience of retrograde intrarenal surgery in the treatment of upper urinary tract stones

Yıl 2021, Cilt: 13 Sayı: 1, 23 - 28, 31.01.2021

Yasin Yitgin Ayhan Karaköse Ekrem Akdeniz

Öz

Objective: The purpose of this study was to evaluate results for patients with renal or proximal ureter stone disease and undergoing retrograde intrarenal surgery (RIRS).

Material and Methods: Demographic, clinical, operative and postoperative datas from 99 patients who underwent RIRS for upper urinary tract stones between March 2019 and May 2020 were analyzed retrospectively. Non-contrast computed tomography (CT) was routinely performed on all patients. Stone location and size were assessed using CT. Achieving stone-free status or residual stone size ≤ 2 mm were regarded as operational success.

Results: RIRS was performed on 99 patients, 60 (60.6%) men and 39 (39.4%) women, with a mean age of 44.9 ± 13.1 years (range, 20 - 74). RIRS was applied to the right unit in 48 patients and to the left in 50. The procedure was performed on both sides in the same session in one case. The stone was in the kidney in 78 patients and in the proximal ureter in 21. The mean stone burden was 18.5 ± 6.9 mm (range, 7 - 35), and the mean operative time was 70.6 ± 23.8 minutes (range, 40 - 125). All patients were discharged on the first postoperative day. No complications occurred during surgery or the postoperative period. The stone free rate was 90.8%.

Conclusion: We believe that the RIRS procedure is a minimally invasive technique that can be used instead of percutaneous nephrolithotomy as experience increases and technology advances.

Anahtar Kelimeler

Flexible ureterorenoscopy, retrograde intrarenal surgery, upper urinary tract stone

Üst üriner sistem taşları tedavisinde retrograd intrarenal cerrahi deneyimlerimiz

Öz

Amaç: Bu çalışmada böbrek veya proksimal üreter taşı nedeniyle retrograd intrarenal cerrahi (RİRC) uyguladığımız hastaların sonuçlarını değerlendirmeyi amaçladık.

Gereç ve Yöntemler: Mart 2019 ile Mayıs 2020 tarihleri arasında böbrek ve proksimal üreter taşlarına yönelik RİRC uygulanan 99 hastanın demografik, klinik, operatif ve postoperatif verileri retrospektif olarak değerlendirildi. Tüm hastalara kontrastsız bilgisayarlı tomografi yapılarak taş lokalizasyonu ve taş boyutu değerlendirildi. Postoperatif kontrolde, radyolojik olarak taş olmaması veya 2 mm ve altı fragmanlar taşsızlık olarak kabul edildi.

Bulgular: Çalışmaya yaş ortalaması 44,9 ± 13,1 yıl (20 - 74) olan toplam 99 hasta alındı. Hastaların 60’ı (60,6%) erkek ve 39’u (39,4%) kadındı. 48 (%48,4) hastaya sağ, 50 (%50,5) hastaya sol ve bir (%1,1) hastaya bilateral RİRC operasyonu yapıldı. 78 (% 78,8) hastanın taşı böbrekte iken, 21 (% 21,2) hastanın taşı proksimal üreterdeydi. Ortalama taş büyüklüğü 18,5 ± 6,9 mm (7 - 35) ve ortalama ameliyat süresi 70,6 ± 23,8 dakika (40 - 125) olarak bulundu. Ameliyat sırasında ve sonrasında hastalarda majör bir komplikasyon gelişmedi. Toplam 90 hastada taşsızlık sağlandı ve genel başarı oranımız % 90,9 olarak bulundu.

Sonuç: Gelişen teknoloji ve artan deneyim ile birlikte RİRC üst üriner sistem taşlarının tedavisinde düşük komplikasyon ve yüksek taşsızlık oranları ile oldukça başarılı bir tedavi yöntemi olduğunu düşünmekteyiz.

Anahtar Kelimeler

Fleksibl üreterorenoskopi, retrograd intrarenal cerrahi, üst üriner sistem taş hastalığı

Kaynakça

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