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Tek Seans-Tek Giriş Perkütan Nefrolitotomi Deneyimlerimiz

Our Experience With Single Session-Single Access Percutaneous Nephrolithotomy

Journal Name:

  • Uludağ Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2009

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Abstract (2. Language): 
In this study, we present our results with single session-single access PCNL in a group of patients whose most of the stones were incomplete staghorn form. Single session-single access PCNL has been performed in 138 patients between April 2006-March 2008. Percutaneous Access has been established under C-arm fluoroscopic guidance with a prone position. Dilation was made with Amplatz dilators and 30F sheath has been placed. Disintegration has been achieved with 26 F rigid nephroscope and pneumatic lithotripter. 18F nephrostomy tube has been placed at the end of the procedure. There were 95 male and 43 female patients with a mean age of 47.9 (3-76) years. Stones were located at the right side in 60 and left side in 78 patients. Mean stone size was 745.5 mm2, and mean operative time was 99.3 minutes. Stonefree rate was 85.5% (118/138). Six patients (4.3%) received blood transfusion. The mean volume of irrigation fluid used was 11.4 liters. The mean nephrostomy removal day and postoperative hospital stay was 2.5 and 3.7 days, respectively. Our findings reveal that PCNL as a minimally invasive modality preserves its efficiency and safety even in single session and single access technique.
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Abstract (Original Language): 
Bu çalışmada çoğunluğunu inkomplet staghorn taşlı hastaların oluşturduğu ve tek seans-tek akses PNL uyguladığımız vakaların sonuçlarını sunmaktayız. Nisan 2006-Mart 2008 tarihleri arasında kliniğimizde 138 hastaya tek seans-tek akses PNL uygulandı. Perkütan girişim C kollu floroskopi altında hastaya yüzüstü (prone) pozisyonu verilerek yapıldı. Amplatz dilatatörlerle giriş yolu genişletildi ve 30 F Amplatz sheat yerleştirildi. Perkütan taş kırma ve taşların temizlenmesi 26 F rigid nefroskop ve pnömatik litotriptörle yapıldı. Operasyonun bitiminde 18 F nefrostomi tüpü takıldı. Değerlendirmeye yaş ortalamaları 47.9 (3-76) olan 95 erkek ve 43 kadın olgu alındı. 60 sağ, 78 sol üniteye PNL uygulandı. Ortalama taş boyutu 745,5 mm 2 , operasyon süresi 99,3 dakikaydı. Taşsızlık oranı 118/138 (%85,5) olarak hesaplandı. Postoperatif dönemde 6 (%4,3) hastaya toplam 7 ünite kan transfüzyonu yapıldı. Cerrahi sırasında ortalama 11,4 lt irrigasyon sıvısı kullanıldı. İki hastada komplike İYE gelişti. Nefrostomi kalış süresi ortalama 2,5 gün, hastanede kalış süresi ortalama 3,7 gündü. Bu bulgular, böbrek taşlarının tedavisinde minimal invaziv bir yöntem olan PNL’nin tek seansta tek akses kullanılarak da etkinlik ve güvenilirliğini koruduğunu göstermektedir.
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  • Turkish

REFERENCES

References: 

1- Fernström I, Johansson B. Percutaneous pyelolithotomy. A new
extraction technique. Scand J Urol Nephrol. 1976;10(3):257-9.
2- Smith AD, Lange PH, Fraley EE. Applications of percutaneous
nephrostomy. New challenges and opportunities in endourology. J Urol. 1979 Mar;121(3):382.
3- Paik ML, Wainstein MA, Spirnak P, Hampel N, Resnick MI.
Current indications for open stone surgery in the treatment of
renal and ureteral calculi. J Urol 1998;159(2):374-8.
4- Wolf JS, Clayman RV: Percutaneous nephrostolithotomy. What
is its role in 1997?. Urol Clin North Am. 1997; 24(1): 43-58.
5- Jones JA, Lingeman JE, Steidle CP. The roles of extracorporeal
shock wave lithotripsy and percutaneous nephrostolithotomy in
the management of pyelocaliceal diverticula. J Urol. 1991; 146:
724,
6- Chandhoke PS, Albala DM, Clayman RV. Long-term
comparison of renal function in patients with solitary kidneys
and/or moderate renal insufficiency undergoing extracorporeal
shock wave lithotripsy or percutaneous nephrolithotomy. J Urol.
1992; 147(5): 1226-30,
7- Kim SC, Kuo RL, Lingeman JE Percutaneous nephrolithotomy:
an update, J Urol. 2005;173(4):1199.
8- Pearle MS, Clayman RV. Outcomes and selection of surgical
therapies of stones in the kidney and ureter. In: Coe FL, Favus
MJ, Pak CYC, Parks JH, Preminger GM (Eds). Kidney Stones:
Medical and surgical management. Philadelphia; Lippincott
Williams & Wilkins, 1995;709-55.
9- Deane LA, Clayman RV. Advances in percutaneous
nephrostolithotomy Urol Clin North Am. 2007, 34:383-95.
10- Khaitan A, Gupta NP, Hemal AK, Dogra PN, Seth A, Aron M.
Post-ESWL, clinically insignificant residual stones: reality or
myth? Urology. 2002 Jan;59(1):20-4.
11- Akıncı M, Esen T, Tellaloglu S. Urinary stone disease in
Turkey: An updated epidomiological study. Eur Urol 1991; 20:
200-3.
12- Snyder JA, Smith AD. Staghorn calculi. Percutaneous
extraction versus anathrophic nephrolithotomy. J Urol 1986;
136: 351-4.
13- Timoney AG, Payne SR, Walmsley BH, Vinnicombe J,
Abercrombie GF. Partial nephrectomy: An option in calculus
disease? Br J Urol 1988; 62: 511-4
14- J.de la Rosette, G.Alivizatos, S. Madersbacher, ve ark.
Ürolitiazis kılavuzları, EAU Kılavuzları 2007;54
15- Segura JW, Preminger GM, Assimos DG, et al. Nephrolithiazis
clinical guidelines panel summary report on the management of
staghorn calculi. J Urol. 1994;151:1648-51,
16- Segura JW, Patterson DE, LeRoy AJ. Combined percutaneous
ultrasonic lithotripsy and extra corporeal shock wave lithotripsy
for struvite staghorn calculi. World J Urol 1987; 5: 245-7.
17- Assimos DG, Wrenn JJ, Harrison LH, et al. A comparison of
anatrophic nephrolithotomy and percutaneous nephrolithotomy
with and witout extracorporeal shock wave lithotripsy for
management of patients with staghorn calculi. J Urol 1991;
145: 710-4
18- Koko AH, Onuora VC, Al-Turkey MA, Al Moss M, Meabed
AH, Al Jawani NA.
19- Percutaneous nephrolithotomy for complete staghorn renal
Stones. Saudi J Kidney Dis Transpl. 2007 ;18:47-53
20- Slavković A, Vlajković M, Radovanović M, Sirić Z, Stefanović
V. Combined treatment of immobilization staghorn stones in
14-year old boy. Arch Esp Urol. 2008 ;61:799-807.

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