Üreterolitotripsi Sonrası Distal Üreter Taşlarında Taş Fragmanlarının Çıkarılması İçin Flush-out Tekniği ve Basketin Karşılaştırılması: Prospektif Randomize Çalışma

Yıl 2025, Cilt: 17 Sayı: 3, 157 - 163, 30.09.2025

Metin Savun , Ertuğrul Arıkız , Harun Özdemir , Emin Taha Keskin , Murat Şahan , Halil Lütfi Canat

https://doi.org/10.54233/endourolbull-1744397

Öz

Amaç: Bu prospektif, randomize çalışmada, distal üreter taşı olan hastalarda semi-rigid üreteroskopi sırasında taş fragmanlarının çıkarılması için basket ve flush-out tekniği karşılaştırılmıştır.
Gereç ve Yöntemler: Distal üreter taşı olan 84 hasta eşit olarak iki gruba ayrıldı. Grup 1’e nitinol basket kullanılarak taş çıkarma işlemi uygulanırken, Grup 2’ye irrigasyon basıncıyla üreteroskopun geri çekilmesi yoluyla pasif olarak taş fragmanlarının çıkarılmasını içeren flush-out tekniği uygulandı. Demografik veriler, taş özellikleri, operasyon sonuçları ve komplikasyon oranları kaydedildi.
Bulgular: Demografik veriler ve taş özellikleri iki grup arasında benzerdi. Grup 2, Grup 1’e kıyasla anlamlı derecede daha kısa median operasyon süresi (30’a karşı 45 dakika, p=0,020) ve taş çıkarma süresi (1’e karşı 10 dakika, p=0,001) gösterdi. Ameliyat sonrası birinci gündeki taşsızlık oranları gruplar arasında benzerdi (%97,6’ya karşı %100, p=1,000). Ameliyat sırasında ve sonrasındaki komplikasyon oranları benzerdi ve Satava, Clavien-Dindo sınıflandırmalarının dağılımında anlamlı bir fark yoktu.
Sonuç: Flush-out tekniği, distal üreter taşları için basket yöntemine güvenli ve etkili bir alternatif olup, daha kısa ameliyat süresi ve taş çıkarma süreleri ile karşılaştırılabilir klinik sonuçlar sunmaktadır. Basitliği ve uygun maliyeti, özellikle yüksek hacimli ve sınırlı kaynaklara sahip kliniklerde günlük üroloji pratiğinde daha yaygın bir şekilde uygulanmasını destekleyebilir.

Anahtar Kelimeler

cerrahi aletler , lazer litotripsi , üreteral taşlar , üreteroskopi

Etik Beyan

Başakşehir Çam ve Sakura Şehir Hastanesi Klinik Araştırma Etik Kurulu Tarih: 29 Aralık 2021 Karar No: 287.

Destekleyen Kurum

Yazarlar, sunulan çalışma için herhangi bir kuruluştan destek almamıştır.

Comparison of the Flush-out Technique and the Basket for Retrieving Stone Fragments in Distal Ureteral Stones After Ureterolithotripsy: A Prospective Randomized Study

Öz

Objective: This prospective randomized study evaluated the efficacy and safety of the flush-out technique in comparison with conventional basket retrieval for the clearance of stone fragments during semi-rigid ureteroscopy in patients with distal ureteral stones.
Materials and Methods: Eighty-four patients diagnosed with distal ureteral stones were randomly assigned to two equal groups. Group 1 underwent stone retrieval using a nitinol basket. In contrast, group 2 was treated with the flush-out technique, which entails passive fragment expulsion facilitated by irrigation pressure and strategic withdrawal of the ureteroscope. Demographic data, stone characteristics, operative outcomes, and complication rates were recorded.
Results: Demographic data and stone characteristics were comparable between the two groups. The Group 2 exhibited a significantly reduced median operation time (30 vs. 45 minutes, p=0.020) and stone retrieval time (1 vs. 10 minutes, p=0.001) in comparison to the Group 1. The stone-free rates on postoperative day one were similar between the groups (97.6% vs. 100%, p=1.000). Intraoperative and postoperative complication rates were analogous, with no significant differences observed in the distribution of the Satava and Clavien-Dindo classifications.
Conclusion: The flush-out technique is a safe and efficacious alternative to basket retrieval for managing distal ureteral stones, yielding comparable clinical outcomes while reducing both operative and stone retrieval times. Its simplicity and cost-effectiveness may facilitate broader adoption in routine urological practice, particularly in high-volume and resource-constrained settings.

Anahtar Kelimeler

lithotripsy , laser , surgical instruments , ureteral calculi , ureteroscopy

Etik Beyan

This prospective, randomized study was conducted in accordance with the principles outlined in the Declaration of Helsinki by the World Medical Association, titled "Ethical Principles for Medical Research Involving Human Subjects." Başakşehir Çam and Sakura City Hospital Clinical Research Ethics Committee Date: December 29, 2021 Decision No: 287.

Destekleyen Kurum

The authors did not receive support from any organization for the submitted work.

Kaynakça

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