Araştırma Makalesi
Yıl 2020,
, 219 - 223, 21.07.2020
Öz
Objective: Comparison of tubeless percutaneous nephrolithotomy (tPCNL) and standard percutaneous nephrolithotomy (sPCNL) performed in renal stone surgeries in terms of patient comfort, post-operative hospitalization time and complications.
Method: In our clinic, sPCNL was performed by placing a nephrostomy catheter in 87 patients out of 133 patients, and tPCNL was performed by placing a Double J catheter in 46 patients.
Results: There was no statistical difference between the two patient groups in data such as age, gender, stone size, guy's score, stone variable, and side (p>0.05). Also in the perioperative data; operation time, stone-free rates, perioperative hemoglobin decrease, blood transfusion, and statistical difference between the two groups were not found (p>0.05). There was no significant difference between stone groups such as stonelessness rate, post-op hemoglobin decrease, operation time and stone properties such as stone size, guy's score, stone variable (p>0.05). Analgesia dose, length of hospitalization, return to activity (p=0.001), fever during post-op period (p=0.016), urine leakage from the nephrostomy tract (p=0.002) were found to be statistically significant lower in the tPCNL group. More tPCNL was performed on the upper pole stones which was found statistically significant (p=0.008).
Conclusions: Tubeless PCNL operation is an end urological method that can be applied effectively and safely by experienced surgeons with advantages such as less pain in early postoperative period, shorter hospitalization, returning to physical activity earlier, less fever and less urine leakage than nephrostomy tract.
Anahtar Kelimeler
Kaynakça
- 1- Türk C, Petřík A, Sarica K, et al. EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. Eur Urol. 2016;69(3):468–474. doi:10.1016/j.eururo.2015.07.040
- 2- Bellman GC, Davidoff R, Candela J, Gerspach J, Kurtz S, Stout L. Tubeless percutaneous renal surgery. J Urol 1997;157:1578-1582.
- 3- Mercado A, Fernández MI, Recabal P, et al. Immediate postoperative morbidity in patients with indwelling double-J stent versus overnight-externalized ureteral catheter after tubeless percutaneous nephrolithotomy: a prospective, randomized study. Urolithiasis 2013;41:253-256.
- 4- Umut Gonulalan, Tufan Cicek, Okan Istanbulluoglu, Murat Kosan, Bulent Ozturk, Hakan Ozkardes. 2013. Tubeless percutaneous nephrolithotomy is effective and safe in short- and long-term urinary drainage. Urolithiasis 41, 341-346.
- 5- Delnay KM, Wake RW. Safety and efficacy of tubeless percutaneous nephrolithotomy. World J Urol 1998;16:375–377.
- 6- Feng MI, Tamaddon K, Mikhail A, Kapstein JS, Bellman GC. Prospective randomized study of various techniques of percutaneous nephrolithotomy. Urology 2001;58:345–350.
- 7- Agrawal MS, Agrawal M, Gupta A, Bansal S, Yadav A, Goyal J. A randomized comparison of tubeless and standard percutaneous nephrolithotomy. J Endourol. 2008;22(3):439–442. doi:10.1089/end.2007.0118
- 8- Paul EM, Marcovich R, Lee BR, Smith AD. Choosing the ideal nephrostomy tube. BJU Int 2003;92:672–677.
- 9- Weld KJ, Wake RW. Simultaneous bilateral tubeless percutaneous nephrolithotomy. Urology 2000;56:1057
- 10- Shah HN, Kausik VB, Hegde SS, Shah JN, Bansal MB. Safety and efficacy of bilateral simultaneous tubeless percutaneous nephrolithotomy. Urology 2005;66:500–504.
- 11- . Shah HN, Kausik VB, Hegde SS, Shah JN, Bansal MB. Tubeless percutaneous nephrolithotomy: A prospective feasibility study and review of previous reports. BJU Int 2005;96:879–883.
- 12- Gonen M, Ozturk B, and Ozkardes H. Double-J Stenting Compared with One Night Externalized Ureteral Catheter Placement in Tubeless Percutaneous Nephrolithotomy. J Endourol 2009; 23(1): 27-32
- 13- Chung HS, Jung SI, Yu HS, et al. Modified totally tubeless percutaneous nephrolithotomy: Is it an effective and safe treatment option for renal and upper ureteral stones?. Wideochir Inne Tech Maloinwazyjne. 2016;11(4):240–246. doi:10.5114/wiitm.2016.64447
- 14- Gupta S, Maurya AK, Pal DK. Observational prospective study for surgical outcome and anesthetic feasibility of tubeless and totally tubeless supine PCNL: A single centre initial experience. Turk J Urol. 2018;45(2):146–149. Published 2018 Dec 4. doi:10.5152/tud.2018.97345
Yıl 2020,
, 219 - 223, 21.07.2020
Öz
Amaç: Renal taş cerrahilerinde yapılan tüpsüz perkütan nefrolitotomi (tPCNL) ve tüplü perkütan nefrolitotominin (sPCNL) etkinliği, hasta konforu, post operatif yatış süresi ve komplikasyonlar açısından kıyaslanması.
Yöntem: Kliniğimizde PCNL yapılan 133 hastadan 87 hastaya standart olarak nefrostomi kateteri yerleştirilerek yapılan sPCNL ve 46 hastaya Double J kateter yerleştirilerek uygulanan tPCNL yapıldı.
Bulgular: Yaş, cinsiyet, taş boyutu, Guy taş skoru, taş değişkenliği, taraf gibi verilerde iki hasta grubu arasında istatistiksel fark yoktu (p>0,05). Perioperatif verilerde; operasyon süresi, taşsızlık oranları, peroperatif hemoglobin düşüşü, kan transfüzyonu açısından iki grup arasında istatistiksel fark bulunmadı (p>0,05). Gruplar arasında taşsızlık oranı, post-op hemoglobin düşüklüğü, operasyon süresi gibi ve taş boyutu, Guy taş skoru, taş değişkenliği gibi taş özelliklerde anlamlı farklılık tespit edilemedi (p>0,05). Analjezi dozu, yatış süresi, aktiviteye dönüş (p=0.001), post-op dönemde ateş (p=0,016), nefrostomi traktından idrar kaçağı (p=0,002) tPCNL grubunda istatistiksel olarak anlamlı düşük bulundu. Üst pol taşlarına anlamlı olarak daha çok tPCNL yapıldığı (p=0,008) tespit edildi
Sonuç: tPCNL operasyonu, erken postoperatif dönemde daha az ağrı, daha kısa hastanede kalış süresi, erken aktiviteye dönüş, daha az ateş ve nefrostomi traktından daha az idrar kaçağı gibi avantajları ile deneyimli cerrahlar tarafından etkin ve güvenle uygulanabilecek endoürolojik bir yöntemdir.
Anahtar Kelimeler
Nefrolitotomi perkütan, böbrek taşları, ürolojik cerrahi işlemler
Teşekkür
İlginiz için şimdiden teşekkürler ...
Kaynakça
- 1- Türk C, Petřík A, Sarica K, et al. EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. Eur Urol. 2016;69(3):468–474. doi:10.1016/j.eururo.2015.07.040
- 2- Bellman GC, Davidoff R, Candela J, Gerspach J, Kurtz S, Stout L. Tubeless percutaneous renal surgery. J Urol 1997;157:1578-1582.
- 3- Mercado A, Fernández MI, Recabal P, et al. Immediate postoperative morbidity in patients with indwelling double-J stent versus overnight-externalized ureteral catheter after tubeless percutaneous nephrolithotomy: a prospective, randomized study. Urolithiasis 2013;41:253-256.
- 4- Umut Gonulalan, Tufan Cicek, Okan Istanbulluoglu, Murat Kosan, Bulent Ozturk, Hakan Ozkardes. 2013. Tubeless percutaneous nephrolithotomy is effective and safe in short- and long-term urinary drainage. Urolithiasis 41, 341-346.
- 5- Delnay KM, Wake RW. Safety and efficacy of tubeless percutaneous nephrolithotomy. World J Urol 1998;16:375–377.
- 6- Feng MI, Tamaddon K, Mikhail A, Kapstein JS, Bellman GC. Prospective randomized study of various techniques of percutaneous nephrolithotomy. Urology 2001;58:345–350.
- 7- Agrawal MS, Agrawal M, Gupta A, Bansal S, Yadav A, Goyal J. A randomized comparison of tubeless and standard percutaneous nephrolithotomy. J Endourol. 2008;22(3):439–442. doi:10.1089/end.2007.0118
- 8- Paul EM, Marcovich R, Lee BR, Smith AD. Choosing the ideal nephrostomy tube. BJU Int 2003;92:672–677.
- 9- Weld KJ, Wake RW. Simultaneous bilateral tubeless percutaneous nephrolithotomy. Urology 2000;56:1057
- 10- Shah HN, Kausik VB, Hegde SS, Shah JN, Bansal MB. Safety and efficacy of bilateral simultaneous tubeless percutaneous nephrolithotomy. Urology 2005;66:500–504.
- 11- . Shah HN, Kausik VB, Hegde SS, Shah JN, Bansal MB. Tubeless percutaneous nephrolithotomy: A prospective feasibility study and review of previous reports. BJU Int 2005;96:879–883.
- 12- Gonen M, Ozturk B, and Ozkardes H. Double-J Stenting Compared with One Night Externalized Ureteral Catheter Placement in Tubeless Percutaneous Nephrolithotomy. J Endourol 2009; 23(1): 27-32
- 13- Chung HS, Jung SI, Yu HS, et al. Modified totally tubeless percutaneous nephrolithotomy: Is it an effective and safe treatment option for renal and upper ureteral stones?. Wideochir Inne Tech Maloinwazyjne. 2016;11(4):240–246. doi:10.5114/wiitm.2016.64447
- 14- Gupta S, Maurya AK, Pal DK. Observational prospective study for surgical outcome and anesthetic feasibility of tubeless and totally tubeless supine PCNL: A single centre initial experience. Turk J Urol. 2018;45(2):146–149. Published 2018 Dec 4. doi:10.5152/tud.2018.97345
Toplam 14 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Cerrahi Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 21 Temmuz 2020 |
| Kabul Tarihi | 20 Haziran 2020 |
| Yayımlandığı Sayı | Yıl 2020 |