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Medical Journal of Süleyman Demirel University

2602-2109

Süleyman Demirel Üniversitesi

10.17343/sdutfd.1114005

Surgery

Cerrahi

10-20 MM ALT POL BÖBREK TAŞLARININ TEDAVİSİNDE RETROGRAD İNTRARENAL CERRAHİYE KARŞI MİNİ PERKÜTAN NEFROLİTOTOMİ: EĞİLİM SKORU EŞLEŞTİRMELİ BİR ANALİZ

RETROGRADE INTRARENAL SURGERY VS MINI-PERCUTANEUS NEPHROLITHOTOMY IN THE MANAGEMENT OF 10-20 MM LOWER POLE KIDNEY STONES: A PROPENSITY MATCHED ANALYSIS

https://orcid.org/0000-0002-1101-1149

Guzel

Ahmet

AYDIN DEVLET HASTANESİ

https://orcid.org/0000-0002-6333-0213

Anıl

Hakan

ADANA SEYHAN DEVLET HASTANESİ

https://orcid.org/0000-0003-0293-9989

Yıldız

Ali

İSTANBUL OKAN ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0001-8288-5313

Karamık

Kaan

KORKUTELİ DEVLET HASTANESİ

https://orcid.org/0000-0003-0555-2528

Akdemir

Serkan

ÖZEL TINAZTEPE HASTANESİ

https://orcid.org/0000-0001-9860-5910

Oksay

Taylan

SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0001-8331-8628

Arslan

Murat

İSTANBUL OKAN ÜNİVERSİTESİ, TIP FAKÜLTESİ

09 30 2022

29 3 414 421 05 08 2022 06 28 2022

1994

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

AmaçÜroloji kılavuzlarında 10-20 mm arası alt pol taşlarındaözellikle ekstrakorporal şok dalga litotripsi(SWL)'nin başarısız olduğu veya SWL'nin uygun olmadığıdurumlarda endoürolojik tedaviler olan perkütannefrolitotomi (PCNL) ve retrograd intrarenal cerrahi(RİRC) önerilmektedir. Bu çalışmada 10-20 mmarası alt pol taşlarında RİRC ile mini perkütan nefrolitotomi(m-PCNL) uygulanan hastaların sonuçlarınıkarşılaştırdık.Gereç ve Yöntem2020 ile 2022 yılları arasında 10-20 mm arası alt polböbrek taşı nedeniyle endoürolojik tedavi (RİRC veyam-PCNL) uygulanan 116’sı RİRC, 71’i m-PCNL olantoplam 187 hastanın dosyaları retrospektif olarak incelendi.Preoperatif yanlılıkları önlemek için 1:1 oranıtemel alınarak eğilim skoru eşleştirmesi (propensityscore-match) uygulandı. Analiz sonucuna göre RİRCuygulanan 65 hasta ve m-PCNL uygulanan 65 hastaçalışmaya dahil edildi. İki grup arasında intraoperatif(operasyon süresi, floroskopi süresi) ve postoperatifbulgular (hastane yatış süresi, hematokrit düşüşü,taşsızlık oranları ve komplikasyonlar) karşılaştırıldı.Operasyon sonrası 4 mm veya daha büyük taşsaptanması klinik anlamlı rezidü olarak tanımlandı.Komplikasyonlar Clavien skorlama sistemine göre veintraoperatif-postoperatif olarak sınıflandırıldı.BulgularHer iki grup, demografik özellikler (yaş, cinsiyet, vücutkitle indeksi), radyografik taş karakteristikleri (taşboyutu, taş lateralitesi, taş opasitesi, ve taş dansitesi)açısından karşılaştırıldığında istatistiksel olarak anlamlıfark gözlenmedi. Operasyon süresi, floroskopisüresi, hastane yatış süresi açısından gruplar karşı-laştırıldığında, RİRC grubunda bu süreler istatistikselolarak anlamlı derecede daha kısaydı (p

ObjectiveIn urology guidelines, endourological treatmentssuch as percutaneous nephrolithotomy (PCNL)and retrograde intrarenal surgery (RIRS) arerecommended for lower pole stones with a diameter of10-20 mm, especially in cases where extracorporealshock wave lithotripsy (SWL) fails or SWL is notappropriate. In this study, we compared the results ofpatients who underwent RIRS and mini percutaneousnephrolithotomy (m-PCNL) for lower pole stones witha diameter of 10-20 mm.Material and MethodThe data of 187 patients (116 RIRS, 71 m-PCNL)who underwent endourological treatment (RIRS orm-PCNL) for 10-20 mm lower pole kidney stonesbetween 2020 and 2022 were retrospectivelyanalyzed. To avoid preoperative biases, propensityscore-matching was applied based on a 1:1 ratio.According to the results of the analysis, 65 patientswho underwent RIRS and 65 patients who underwentm-PCNL were included in the study. Intraoperative(operation time, fluoroscopy time) and postoperativefindings (hospitalization time, drop in hematocrit,stone-free rates, and complications) were comparedbetween the two groups. Postoperative stonedetection of 4 mm or larger was defined as clinicallysignificant residue. Complications were classifiedaccording to the Clavien scoring system and asintraoperative-postoperative.ResultsWhen the two groups were compared in terms ofdemographic characteristics (age, gender, bodymass index) and radiographic stone characteristics(stone size, stone laterality, stone opacity, and stonedensity), no statistically significant difference wasobserved. When the groups were compared in termsof operation time, fluoroscopy time and hospitalizationtime, these periods were statistically significantlyshorter in the RIRS group (p

Böbrek Taşı Mini Perkütan Nefrolitotomi Retrograd İntrarenal Cerrahi

Kidney Stone Mini Percutaneous Nephrolithotomy Retrograde Intrarenal Surgery

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