KADAVERİK BÖBREK NAKLİNDE İNTRAOPERATİF ÜRETERAL KATETER KULLANIMININ BAKTERİÜRİ VE KOMPLİKASYON OLUŞUMUNA ETKİSİ

Öz

Amaç: Kadaverik böbrek naklinde, intraoperatif üreteral kateter kullanımının bakteriüri ve ürolojik komplikasyonlara olan etkisini incelemeyi amaçladık. Gereç ve Yöntem: Bu kesitsel çalışmada İstanbul Üniversitesi, İstanbul Tıp Fakültesi Transplantasyon Ünitesi’nde kadavradan böbrek nakli yapılan 150 hasta çalışmaya alındı. Üreteral kateter kullanılmayan 78 hasta ve üreteral kateter kullanılan 72 hasta olduğu tespit edildi. Bu iki hasta grubu postoperatif erken dönem ürolojik komplikasyonlar, nakil sonrası 1. ayda görülen bakteriüri varlığı açısından karşılaştırıldı. Bulgular: Üreteral kateter kullanılan olgularda, postoperatif erken dönem ürolojik komplikasyon sıklığı anlamlı düzeyde azalmıştır (p=0,004). İlginç bir şekilde üreteral kateter kullanılan hastalarda, nakil sonrası birinci ayda görülen bakteriüri sıklığı da anlamlı düzeyde azalmıştır (p<0,001). Üreteral kateter kullanılan hastalarda, anti-timosit globulin kullanım süresi (p=0,003) ve foley kateter kullanım süresi (p<0,001) üreteral kateter kullanılmayan gruba göre anlamlı düzeyde kısa saptanmıştır. Sonuç: Kadaverik böbrek nakli olgularında rutin üreteral kateter kullanımında ürolojik komplikasyonlar daha az görülmektedir. Kateter kullanılan grupta erken bakteriüri görülme riskinin artmadığı hatta azalmış olduğu saptanmıştır. Bu anlamlı düzeyde azalmanın, üreteral kateterli hasta grubunda anti-timosit globulin kullanım süresi ve foley kateter kullanım süresinin anlamlı düzeyde kısa olması ile ilşkili olduğu düşünülmüştür. Bu nedenle kadaverik böbrek naklinde rutin intraoperatif üreteral kateter kullanımı önerilmektedir.

Anahtar Kelimeler

• Bakteriüri
• Komplikasyonlar
• Kadaverik böbrek nakli
• Üreteral kateter

THE EFFECT OF INTRAOPERATIVE URETERAL CATHETER USAGE ON BACTERIURIA AND COMPLICATIONS IN DECEASED DONOR RENAL TRANSPLANTATION

Öz

Objective: The use of ureteral catheters in renal transplantation is controversial. We aimed to investigate the effect of intraoperative catheter use on bacteriuria and urological complications in deceased donor renal transplantation. Material and Method: Study design is cross sectional study. A total of 150 patients who underwent deceased donor renal transplantation in the Istanbul University Istanbul Faculty of Medicine Transplantation Unit were included in the study. Ureteral catheters were used in 72 patients but not in the remaining 78. The two patient groups were compared in terms of the incidence of early postoperative urological complications and bacteriuria in the first month after transplantation. Result: Ureteral catheter usage significantly reduced the frequency of early postoperative urological complications (p=0.004). The frequency of bacteriuria in the first month after transplantation was significantly lower in patients using ureteral catheters (p<0.001). In patients with ureteral catheters, the duration of anti-thymocyte globulin administration (p=0.003) and Foley catheter usage (p<0.001) was found to be significantly shorter than in the group without ureteral catheters. Conclusion: The routine use of ureteral catheters results in fewer urological complications in patients with deceased donor renal transplantation. Catheter use does not increase, and even lowers, the risk of early bacteriuria. The significant reduction in early bacteriuria in patients with ureteral catheters is associated with significantly shorter durations of anti-thymocyte globulin and Foley catheter usage. Therefore, the routine use of intraoperative ureteral catheters is recommended in deceased donor renal transplantation.

Anahtar Kelimeler

• Bacteriuria
• Complications
• Deceased donor renal transplantation
• Ureteral Catheter

Kaynakça

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