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BÖBREK ALT KALİKS TAŞLARININ TEDAVİSİNDE VE TEKRAR TAŞ OLUŞUMUNDA KISMİ NEFREKTOMİNİN ROLÜ

MANAGEMENT OF LOWER POLE NEPHROLITHIASIS AND STONE RECURRENCE: PARTIAL NEPHRECTOMY

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Aim: Renal stone disease is a frequently recurrent disease. Among the renal stone diseases 25-35% is localized to lower pole. Despite different treatments of the lower caliceal stones, partial nephrec¬tomy is assumed to decrease the rate of recurrence. Material and Method: In this study fifty-seven patients, (29 with lower pole nephrectomy and 28 with pyelolithotomy, nephrolithotomy and pyelonephrolithotomy) who were surgically treated for their lower caliceal stones, were re-evaluat- ed in our clinic retrospectively. Infundibulopelvic angle, infundibulum length and diameter were measured by standard IVP according to the renal anatomy definition made by Sampaio et al.. The mean follow-up period for all the above mentioned patients was 79 months. Results: Whereas the mean infundibulopelvic angle of the patients, treated with partial nephrectomy, increased from 57 degrees preoperatively to 108 degrees postoperatively, the angle of the patients treated with pyelolithotomy, nephrolithotomy and pyelonephrolithotomy did not change. During the follow-up period, the recurrence rate in the patients, treated with partial nephrectomy, was in 78 months 10 percent, but in the patients; treated with pyelolithotomy, nephrolithotomy and pyelonephrolithoto¬my, in 80 months 21 percent. Conclusion: Partial nephrectomy decreases the recurrence rate of lower pole renal stones through eliminating the anatomical factors that cause stone formation.
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Abstract (Original Language): 
Amaç: Böbrek taş hastalığı, tedavi edildikten sonra sık nükseden bir hastalıktır. Böbrek taşlarının % 25-35'ini alt kaliks taşları oluşturmaktadır. Alt kaliks taşlarının tedavisinde pek çok seçenek olmasına rağmen kısmi nefrektominin nüks oranlarını azalttığı belirtilmiştir (1-4). Gereç ve yöntem: Kliniğimizde böbrek alt kaliks taşı teşhisi konan ve cerrahi tedavisi yapılan 57 hasta retrospektif olarak değerlendirildi. Böbrek anatomisi Sampaio ve ark. tarif ettikleri şekilde standart IVU' lerle değerlendiril¬erek, infundibulapelvik açı, infundibulum uzunluğu ve çapı ölçüldü. Alt pol nefrektomisi yapılan 29 hasta ile pyelolitotomi, nefrolitotomi ve pyelonefrolitotomi yapılan 28 hasta ortalama 79 ay takip edil¬di. Bulgular: Kısmi nefrektomi yapılan hastaların ameliyat öncesi ölçülen infundibulapelvik açı orta¬lamaları 57 dereceden ameliyat sonrası 108 dereceye yükselirken; pyelolitotomi, nefrolitotomi ve pyelonefrolitotomi yapılan hastalarda ortalama açı değerlerinde farklılık gözlenmedi. Alt pol nefrek¬tomisi yapılan hastalarda 78 aylık takip sonucu taş nüksü oranı % 10, pyelolitotomi, nefrolitotomi ve pyelonefrolitotomi yapılan hastalarda ise 80 aylık takip sonucu % 21 idi. Sonuç: Kısmi nefrektomi ile alt kaliks taşı oluşumuna neden olan anatomik faktörün ortadan kaldırılması ile takiplerdeki taş nüks oranlarının azalması sağlanmaktadır.
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  • 4
181-187
  • Turkish

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