Our results with flexible ureterorenoscopy in treatment of upper calyceal stones in obese patients

Yıl 2019, Cilt: 2 Sayı: 3, 79 - 83, 01.07.2019

Engin Kölükçü Bekir Süha Parlaktaş

https://doi.org/10.32322/jhsm.521546

Öz

Aim:
Aim of the present study was to analyze the outcomes of obese patients treated
with ureterorenoscopy for upper calyceal stones. 

Material and Method:
Data of obese patients who had flexible ureterorenoscopy for upper calyceal
stones in January 2015-December 2018 period were analyzed retrospectively. Demographic features, stone sizes, stent use after the
operation, operative time, hospital stay, complications and stone-free rate
were evaluated.

Results:
The study included 30 obese patients (18 male and 12 female). Average age was
52.6±12.06 years. Average stone size was 19.46±6.6 mm. Average operative time
was 72.1±16.8 minutes and hospital stay was 1.5±1.1 days. Success rate was
73.3%. Double J stent was placed in 76.6% of the patients after the operation.
In postoperative follow-ups, three patients had severe colic pain, five
patients had hematuria lasted less than 24 hours without need for blood transfusion
and two patients had urinary system infection. No major complications that
could lead to morbidity or mortality were observed in any patients.

Conclusion:
Flexible ureterorenoscopy is an efficient treatment method with its higher
stone-free and lower complication rates for the treatment of upper calyceal
stones in obese patients.

Anahtar Kelimeler

Flexible ureterorenoscopy, obesity, upper calyceal, stone

Obez hastalarda üst kaliks taşlarının tedavisinde fleksible üreterorenoskopi sonuçlarımız

Öz

Amaç: Bu çalışmada üst kaliks taşı tedavisinde fleksible
üreterorenoskopi uyguladığımız obez hastaların sonuçları analiz
edilmiştir.                                                                                                                                                                                                                         

Gereç ve Yöntem: Ocak
2015-Aralık 2018 tarihleri arasında üst kaliks taşlarına yönelik fleksible
üreterorenoskopi uygulanan obez hastaların verileri geri dönük olarak analiz
edildi. Hastaların demografik verileri, taş boyutları, ameliyat sonrası stent
kullanımı, ameliyat süreleri, hastanede kalış zamanı, komplikasyon ve taşsızlık
oranı değerlendirildi.                                                                                      

Bulgular: Çalışmaya 18'si
erkek, 12'u kadın olmak üzere 30 obez hasta alındı. Hastaların yaş ortalaması
52.6±12.06 yıl idi. Ortalama taş boyutu 19.46±6.6 idi. Ortalama operasyon
süresi 72.1±16.8  dakika ve ortalama
hastanede kalış süresi 1.5±1.1 gün olarak hesaplandı. Başarı oranı %73.3 olarak
belirlendi. İşlem sonrası hastaların %76.6'sında d-j stent uygulandı.
Postoperatif takiplerinde 3 hastada şiddetli kolik ağrı, 5 hastada kan
transfüzyonu gerektirmeyen 24 saatten kısa süren hematüri ve 2 hastada üriner
sistem enfeksiyonu görüldü. Hiçbir hastada morbite veya mortaliteye neden
olacak major komplikasyon izlenmedi.

Sonuç:
Obez hastalarda üst kaliks taşlarının tedavisinde yüksek taşsızlık ve düşük
komplikasyon oranlarıyla fleksible üreterorenoskopi etkin bir tedavi
yöntemidir.                                                      
                               

Anahtar Kelimeler

Flexible üreterorenoskopi, obezite, üst kaliks, taş

Kaynakça

• Referans1 Kölükçü E, Mercimek MN, Erdemir F. Efficacy and safety of holmium laser lithotripsy in the treatment of posterior urethral Stones. J Clin Anal Med 2018; 9: 552-6. Doi: 10.4328/JCAM.5963.
• Referans2 Akinci M, Esen T, Tellaloğlu S. Urinary stone disease in Turkey: an updated epidemiological study. Eur Urol 1991; 20: 200-3.
• Referans3 Uluocak N, Erdemir F, Atılgan D, Erkorkmaz Ü, Çetin İ, Parlaktaş BS. The prevalence of urinary system stone disease in Tokat province. Turkish Journal of Urology 2010; 36: 81-6.
• Referans4 Balcı GU, Balcı U, Öngel K. Evaluation of overactive bladder symptoms with OAB-V8 form in obese patients. The New Journal of Urology 2013; 8: 6-11.
• Referans5 Caskurlu T, Atis G, Arikan O, Pelit SE, Kilic M, Gurbuz C. The Impact of Body Mass Index on the Outcomes of Retrograde Intrarenal Stone Surgery. Urology 2013; 81: 517-21. Doi:10.1016/j.urology.2012.12.008.
• Referans6 Küçük EV, Sobay R, Tahra A, Bindayı A, Önol FF. Comparison of the safety and effectiveness of flexible ureterorenoscopy in obese and normal weight patient. Haydarpasa Numune Med J 2016; 56: 175-80.
• Referans7 Kölükçü E, Kılıç Ş, Parlaktaş BS, et al. Our results of extracorporeal shock wave lithotripsy treatment in upper ureteral stones. J Health Sci Med 2019; 2: 13-7. Doi: 10.32322/jhsm.486315
• Referans8 Özenoğlu A, Yalnız T, Uzdil Z. The Effect Of Health Education On Nutritional Status And Healthy Life Style Behavior Among University Students. ACU Sağlık Bil Derg 2018; 9: 234-42.
• Referans9 Tedik SE. Healthy Life and Role of Nursing in the Control of Body Weight. Turk J Diab Obes 2017; 2: 54-62. Doi: 10.25048/tjdo.2017.9.
• Referans10 Ekeruo WO, Tan YH, Young MD, et al. Metabolic risk factors and the impact of medical therapy on the management of nephrolithiasis in obese patients. J Urol 2004; 172: 159-63.
• Referans11 Carbone A, Al Salhi Y, Tasca A, et al. Obesity and kidney stone disease: a systematic review. Minerva Urol Nefrol 2018; 70: 393-400. Doi: 10.23736/S0393-2249.18.03113-2.
• Referans12 Carucci LR. Imaging obese patients: problems and solutions. Abdom Imaging 2013: 38: 630-46. Doi: 10.1007/s00261-012-9959-2.
• Referans13 Gökçe E. Obesity and Diagnostic Radiology. J Contemp Med 2013; 3: 218-26. Doi:10.5455/ctd.2013-118.
• Referans14 Baturay F, Topuz C, Ay A, Gültop F. Obesity and Anaesthesia. Okmeydanı Tıp Dergisi 2014; 30: 29-33.
• Referans15 Thomas EJ, Goldman L, Mangione CM, et al. Body mass index as a correlate of postoperative complications and resource utilization. Am J Med 1997; 102: 277-83.
• Referans16 Rosito GA, D’Agostino RB, Massaro J, et al. Association between obesity and a prothrombotic state: The Framingham Offspring Study. Thromb Haemostasis 2004; 91: 683-9.
• Referans17 Güneş M, Pirinçci N, Geçit İ, et al. The Effectiveness of the ESWL Treatment on Clearance Rate of the Urinary System Calculi According to the Stone Localization and Size. Van Med J 2011; 18: 136-40.
• Referans18 Dede O, Şener NC, Baş O, Dede G, Bağbancı MŞ. Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones? Turk J Urol 2015; 41: 20-3. Doi:10.5152/tud.2015.94824.
• Referans19 Olivi B, Védrine N, Costilles T, Boiteux JP, Guy L. [Extra corporeal shock wave lithotripsy in patients with body mass index over 35 Kg/m2]. Prog Urol 2011; 21: 254-9. Doi:10.1016/j.purol.2010.11.005.
• Referans20 Thomas R, Cass AS. Extracorporeal shock wave lithotripsy in morbidly obese patients. J Urol 1993; 150: 30-2.
• Referans21 Bedir S. Percutaneous Nephrolithotomy. Turk Urol Sem 2011; 2: 75-81.
• Referans22 Ötünçtemur A, Beşiroğlu H, Dursun M, et al. The Effect of Obesity on the Outcomes of the Patients Undergoing Percutaneous Nephrolithotomy: Retrospective Study. Okmeydanı Tıp Dergisi 2013; 29: 117-21. Doi:10.5222/otd.2013.117.
• Referans23 Zhou X, Sun X, Chen X, et al. Effect of Obesity on Outcomes of Percutaneous Nephrolithotomy in Renal Stone Management: A Systematic Review and Meta-Analysis. Urol Int 2017; 98: 382-90.
• Referans24 Çaşkurlu T, Atış G. Retrograd İntrarenal Cerrahi’de Son Durum. Endoüroloji Bülteni2014; 7: 36-9. Doi: 10.5350/ENDO2014070110.
• Referans25 Doğan B, Canda AE. Effects of the Use of Laser in Urologic Surgery on Quality of Life of Patients. Turk Urol Sem 2011; 2: 158-61.
• Referans26 Sari E, Tepeler A, Yuruk E, et al. Effect of the body mass index on outcomes of flexibleureterorenoscopy. Urolithiasis 2013; 41: 499-504. Doi: 10.1007/s00240-013-0590-7.
• Referans27 Chew BH, Zavaglia B, Paterson RF, et al. A multicenter comparison of the safety and effectiveness of ureteroscopic laser lithotripsy in obese and normal weight patients. J Endourol 2013; 27: 710-4. Doi: 10.1089/end.2012.0605.
• Referans28 Doluoglu OG, Karakan T, Kabar M, et al. Effectiveness of retrograde intrarenal stone surgery in obese patients. Ir J Med Sci 2016; 185: 847-51. Doi: 10.1007/s11845-015-1379-1.