Retrograt intrarenal cerrahi geriatrik erkek hastalarda böbrek taşı tedavisinde etkin ve güvenilir bir seçenek midir?

Yıl 2021, Cilt: 31 Sayı: 4, 396 - 401, 15.12.2021

Ali Furkan BATUR Mustafa GÜLMEN Kadir BÖCÜ Emre ALTINTAŞ Murat GÜL Mehmet KAYNAR Özcan KILIÇ Serdar GÖKTAŞ

https://doi.org/10.54005/geneltip.972227

Öz

Amaç
Bu çalışmada böbrek taşı tedavisi için kliniğimizde retrograt intrarenal cerrahi(RİRC) uygulanılan geriatrik yaş grubu erkek hastaların etkinlik ve güvenlik sonuçlarının, daha genç yaş hasta grubu ile karşılaştırılarak sunulması amaçlanmıştır.
Gereç ve Yöntem
Kliniğimizde böbrek taşı nedeniyle RİRC uygulanmış olan, 40 yaş üzeri erkek hastaların verileri retrospektif olarak değerlendirildi. Hastalar yaşlarına göre iki gruba ayrıldı: 40-64 yaş (Grup 1) ve 65 yaş ve üzeri (Grup 2). Komorbidite değerlendirilmesi için anestezi risk skoru (ASA) ve modifiye Charlson komorbidite indeksi (MCKİ) kullanıldı. Hastanenin kayıt sisteminden ve hastaların dosyalarından genel bilgiler, komplikasyon bilgileri, renal anormallik varlığı, taşın bulunduğu böbrek ve lokalizasyonu, taşın dansitesi, taşın boyutu, taş sayısı verileri ve postoperatif taş temizlenme verileri elde edildi.
Bulgular
Çalışmaya 233 tanesi Grup 1 (40-64 yaş) ve 61 tanesi Grup 2 (65 yaş ve üstü) olmak üzere toplam 294 hasta alınmıştır. ASA ve MCKİ skorları bakımından Grup 2’de yer alan hastaların skorları Grup 1’e göre istatistiksel olarak anlamlı olarak daha yüksek olarak bulunmuştur (sırasıyla p=.000, p=.000). Gruplar arasında taş dansitesi, taş boyutu, taş hacmi, operasyon süresi, hastanede yatış süreleri ve postoperatif taşsızlık oranları bakımından fark bulunmamıştır. Grup 1’de toplam 25 (%10.7) hastada ve Grup 2’de toplam 10 (%16.4) hastada komplikasyon geliştiği tespit edilmiştir ve gruplar arasında genel komplikasyon oranları açısından istatistiki fark bulunmamıştır (p=.265).
Sonuç
Dünya nüfusunun giderek yaşlanması ile beraber bu hasta grubunun hastalıklarının da en uygun tedavi metodlarıyla tedavi edilmesinin önemi artmıştır. Çalışmamızda RİRC yöntemi ile böbrek taşı tedavisi yaşlı hasta grubunda da güvenli ve etkili olarak çıkmıştır.

Anahtar Kelimeler

Böbrek taşı, Geriatrik hasta, Komorbidite, Komplikasyon, Retrograt intrarenal cerrahi

Is retrograde intrarenal surgery an effective and safe option in the treatment of kidney stones in geriatric male patients?

Öz

Objective
In this study, it was aimed to present the efficacy and safety results of geriatric male patients who underwent retrograde intrarenal surgery (RIRC) in our clinic for the treatment of kidney stones, by comparing them with the younger age group.
Material and Methods
The data of male patients over 40 years of age who underwent RIRC for kidney stones in our clinic were evaluated retrospectively. The patients were divided into two groups according to their age: 40-64 years (Group 1) and 65 years and older (Group 2). The data on the comorbidity status of the patients were compiled from their files. American Society of Anesthesiologists score(ASA) and modified Charlson comorbidity index(MCCI) were used for comorbidity assessment. General information, complication information, presence of renal abnormality, kidney and location of the stone, density of the stone, size of the stone, number of stones and postoperative stone clearance data were obtained from the hospital's registry system and the files of the patients.
Results
A total of 294 patients were included in the study, of which 233 were in Group 1 (40-64 years old) and 61 in Group 2 (65 years and older). In terms of ASA and MCKI scores, the scores of the patients in Group 2 were found to be statistically significantly higher than Group 1 (p=.000, p=.000, respectively). There was no difference between the groups in terms of preoperative DJ catheter set, presence of renal abnormalities and non-functioning kidneys. There was no difference between the groups in terms of stone density, stone size, stone volume, operation time, hospital stay, and postoperative stone-free rates. Complications were detected in 25 (10.7%) patients in Group 1 and in 10 (16.4%) patients in Group 2, and there was no statistical difference between the groups in terms of overall complication rates (p=.265).
Conclusion
With the aging of the world population, the importance of treating the diseases of this patient group with the most appropriate treatment methods has increased. In our study, kidney stone treatment with the RIRC method was found to be safe and effective in the elderly patient group.

Anahtar Kelimeler

Comorbidity, Complication, Geriatric patient, Kidney stone

Kaynakça

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