Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Çocuklarda Üst Üriner Sistem Taşlarında Taş Boyutunun Retrograd İntrarenal Cerrahi Sonuçları Üzerine Etkisi: Retrospektif Klinik Çalışma
Effect of Stone Size on Retrograde Intrarenal Surgery Results in Upper Urinary System Stones in Children: Retrospective Clinical Study
Doğakan YİĞİTa, Semih TÜRKb, Duygu GÜRELc, Elif DURUKANd, Hüseyin Cihan DEMİRELe, Kaya HORASANLIb
aProf. Dr. Cemil Taşçıoğlu Şehir Hastanesi, Çocuk Cerrahisi ve Çocuk Ürolojisi Kliniği, İstanbul, Türkiye
bŞişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, İstanbul, Türkiye
cHakkâri Devlet Hastanesi, Çocuk Cerrahisi Kliniği, Hakkâri, Türkiye
dBaşkent Üniversitesi Tıp Fakültesi, Halk Sağlığı ABD, Ankara, Türkiye
eİstanbul Aydın Üniversitesi Tıp Fakültesi, Üroloji ABD, İstanbul, Türkiye
J Reconstr Urol. 2022;12(2):90-5
doi: 10.5336/urology.2022-91553
Article Language: TR
Full Text
ÖZET
 Amaç: Çocuklarda üst üriner sistem taşlarında, taş boyutunun retrograd intrarenal cerrahi sonuçları üzerine etkisinin araştırılması. Gereç ve Yöntemler: 2015-2021 yılları arasında ameliyat edilmiş 29 hastaya ait 38 renal ünite araştırıldı. Demografik veriler, taşın yerleşim yeri, operasyon süresi, access kılıf kullanımı, stent varlığı, komplikasyonlar, hastanede kalış süresi ve taşsızlık oranları retrospektif olarak incelendi. Hastalar, taş boyutu 2 cm'den küçük olanlar 1. grup, 2 cm ve daha büyük olanlar ise 2. grup olacak şekilde gruplara ayrıldı. İstatistiksel analiz için Mann-Whitney U testi; Ki-kare testi ve Fisher'ın kesin ki-kare testleri kullanıldı. Bulgular: Birinci gruptaki renal ünitelerin ait olduğu hastaların ortalama yaşı 11,26 (3-17) yıl, 2. grubun ise 15,2 (11-17) yıl idi ve aradaki yaş farkı istatistiksel olarak anlamlıydı (p=0.002). Gruplar arasında cinsiyet dağılımı açısından istatistiksel olarak anlamlı bir fark saptanmadı (p=0.254). Taş boyutları 1. grup için ortalama 13 (10-18) mm, 2. grup için ise ortalama 25,9 (20- 45) mm olarak hesaplandı. Birinci grupta ortalama operasyon süresi 51 (30-75) dk iken; 2. grupta ortalama operasyon süresi 66,7 (35-100) dk idi ve aradaki fark istatistiksel olarak anlamlıydı (p=0.014). Birinci gruptaki bir hastada postoperatif ilk 48 saat içerisinde ateş görülürken, 2. gruptaki hiçbir hastada postoperatif dönemde ateş olmadı. Birinci grupta tek seansta taşsızlık oranı %78,3, 2. grupta tek seansta taşsızlık oranı %60 olarak hesaplandı ve bu oranın istatistiksel olarak anlamlı olmadığı görüldü (p=0.285). Sonuç: Retrograd intrarenal cerrahi çocuklarda, özellikle 2 cm'den küçük üst üriner sistem taşlarında, kabul edilebilir taşsızlık oranı ile güvenli şekilde kullanılabilir.

Anahtar Kelimeler: Retrograd intrarenal cerrahi; üriner sistem taşı
ABSTRACT
 Objective: To investigate the effect of stone size on retrograde intrarenal surgery results in upper urinary tract stones in children. Material and Methods: 38 renal units of 29 patients who were operated between 2015-2021 were investigated. Demographic data, stone location, operation time, acces sheath use, presence of JJ stent, complications, length of hospital stay and stone free rates were retrospectively analyzed. Patients who had stones smaller than 2 cm. were grouped as group 1 and, who had 2 cm. and larger were grouped as Group 2. Mann-Whitney U test, chi-square test and Fisher's exact chi-square tests were used for statistical analysis. Results: The mean age of the patients in group 1 to which the renal units belonged was 11.26 (3-17) years, and in Group 2 was 15.2 (11-17) years, and the age difference was statistically significant (p=0.002). There was no statistically significant difference between the groups in terms of gender distribution (p=0.254). Average stone size was 13 (10-18) mm for group 1, 25.9 (20-45) mm for group 2. In group 1, the mean operation time was 51 (30-75) minute and 66.7 (35-100) minutes in Group 2 and the difference was statistically significant (p=0.014). The stonefree rate after the first session was 78.3% in group 1, and 60% in group 2 and this difference was not statistically significant (p=0.285). Conclusion: Retrograde intrarenal surgery can be used safely with an acceptable stone-free rate, especially in children with upper urinary tract stones smaller than 2 cm.

Keywords: Retrograde intrarenal surgery; urinary system stone
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