Comparison of Pneumatic Lithotripter and Holmium-YAG Laser Lithotripter in Supine Mini Percutaneous Nephrolithotomy: A Single-Centre Experience

Yıl 2025, Cilt: 17 Sayı: 2, 54 - 60, 30.05.2025

Cengiz Canakcı , Orkunt Özkaptan , Erdinç Dinçer , Fatih Bıçaklıoğlu , Oğuz Türkyılmaz , Uğur Yılmaz

https://doi.org/10.54233/endourolbull-1603757

Öz

Objective: The aim of this study was to compare the efficacy and safety of lithotripters used in supine mini percutaneous nephrolithotomy.
Material and Methods: Medical record of patients who underwent mini percutaneous nephrolithotomy in supine position between January 2023 and June 2024 due to kidney stone larger than 2 cm were evaluated. Thirty-nine patients were operated with Ho:YAG laser lithotripter (LL) and 54 patients were operated with pneumatic lithotripter (PL). Results of patients’ demographics, stone size, stone density, operation time, stone-free rate (SFR), complications were compared.
Results: Mean age was 49.56±13.02 in LL group and 50.20±14.24 in PL group (p=0.825). Mean stone size was 3184±2117 mm³ in LL group and 4117±2975 mm³ in PL group and the results were similar between groups (p=0.097). Operation time was significantly higher in LL group than PL group (99.8±24.7 min, 85.7±28.1 min, respectively). SFR at postoperative 3rd month was similar between groups (92% in LL, 87% in PL) (p=0.512). Hemoglobin decrease rate (1.5±1.1 g/dL (IQR 1.5 g/dL) (LL) vs. 1.6±1.0 g/dL (IQR 1.6 g/dL) (PL), p=0.513) and overall complication rates (20% vs. 18%, p=0.897, respectively) were similar in the groups.
Conclusion: Both lithotripters can be preferred effectively in supine percutaneous lithotomy. Ballistic lithotripters are still a safe and effective option for mini-PNL with the advantage of reduced operation time.

Anahtar Kelimeler

kidney stone , lithotripsy , Percutaneous nephrolithotomy

Etik Beyan

Dr. Lütfi Kırdar Kartal City Hospital Clinical Trials Ethics Committee Decision No:2024/0l0.99/6/3l, Decision Date:26.07.2024

Destekleyen Kurum

The authors declared that this study has received no financial support.

Supin Mini Perkütan Nefrolitotomide Pnömatik litotriptör ile Holmium-YAG Lazer Litotriptör Karşılaştırması: Tek Merkez Deneyimi

Öz

Amaç: Bu çalışmanın amacı supin mini perkütan nefrolitotomide kullanılan litotriptörlerin etkinlik ve güvenilirliklerini karşılaştırmaktır.
Gereç ve Yöntemler: Ocak 2023 ile Haziran 2024 tarihleri arasında 2 cm’den büyük böbrek taşı nedeniyle supin pozisyonda mini perkütan nefrolitotomi uygulanan hastaların tıbbi kayıtları değerlendirildi. Otuzdokuz hasta Ho:YAG lazer litotriptör (LL) ve 54 hasta pnömatik litotriptör (PL) ile ameliyat edildi. Hastaların demografik özellikleri, taş boyutu, taş yoğunluğu, operasyon süresi, taşsızlık oranı, komplikasyon sonuçları karşılaştırıldı.
Bulgular: Ortalama yaş LL grubunda 49,56±13,02 ve PL grubunda 50,20±14,24 idi (p=0,825). Ortalama taş boyutu LL grubunda 3184±2117 mm³ ve PL grubunda 4117±2975 mm³ idi ve sonuçlar gruplar arasında benzerdi (p=0,097). Operasyon süresi LL grubunda PL grubuna göre istatistiksel olarak daha yüksekti (99,8±24,7 dak, 85,7±28,1 dak, sırasıyla). Ameliyat sonrası 3. ayda taşsızlık oranı gruplar arasında benzerdi (LL’de %92, PL’de %87) (p=0,512). Hemoglobin düşüş oranı (1,5±1,1 g/dL (IQR 1,5 g/dL) (LL) vs. 1,6±1,0 g/dL (IQR 1,6 g/dL) (PL), p=0,513) ve genel komplikasyon oranları (sırasıyla %20 vs. %18, p=0,897) gruplarda benzerdi.
Sonuç: Her iki litotriptör de supin perkütan litotomide etkili bir şekilde tercih edilebilir. Balistik litotriptörler, operasyon süresini kısaltma avantajıyla mini-PNL için hala güvenli ve etkili bir seçenektir.

Anahtar Kelimeler

perkütan nefrolitotomi , böbrek taşı , taş kırma

Etik Beyan

Dr. Lütfi Kırdar Kartal Şehir Hastanesi Etik Kurulu. Karar No: 2024/0l0.99/6/3l, Karar Tarihi: 26.07.2024

Kaynakça

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