Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Yaşlı Hastalarda Staghorn Böbrek Taşı Tedavisinde Perkütan Nefrolitotominin Etkinliği ve Güvenirliği: Kesitsel Tanımlayıcı Araştırma
Efficiency and Reliability of Percutaneous Nephrolithotomy in the Treatment of Staghorn Renal Stone in Elderly Patients: Cross-Sectional Descriptive Research
Kağan Türker AKBABAa , Mehmet Vehbi KAYRAb
aİzmir Bozyaka Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, İzmir, Türkiye
bBaşkent Üniversitesi Adana Dr. Turgut Noyan Uygulama ve Araştırma Merkezi, Üroloji ABD, Adana, Türkiye
J Reconstr Urol. 2023;13(1):5-9
doi: 10.5336/urology.2022-93215
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmada, yaşlı hastalarda staghorn böbrek taşı nedeniyle perkütan nefrolitotomi [percutaneous nephrolithotomy (PCNL)]tedavisinin etkinliği ve güvenirliğini saptamayı amaçladık. Gereç ve Yöntemler: Ocak 2011-Aralık 2021 tarihleri arasında Başkent Üniversitesi Adana Hastanesi Üroloji Kliniğinde staghorn böbrek taşı nedeniyle PCNL uygulanan hastaların verileri retrospektif olarak incelendi. Nöromusküler hastalık öyküsü, böbrek anomalisi, koagülopati, iskelet deformitesi ve soliter böbreği olan hastalar çalışma dışı bırakıldı. Kriterlere uyan 246 hasta çalışmaya dâhil edildi. Hastalar yaş gruplarına göre genç ve yaşlı olarak 2'ye ayırıldı; Grup 1 (18-64 yaş), Grup 2 (≥65 yaş). Genç hastalar kontrol grubu olarak kabul edildi. İki grup arasında taş boyutu, operasyon süresi, floroskopi süresi, operasyon öncesi ve sonrası hemoglobin değeri farkı, yatış süresi, komplikasyon ve başarı oranları karşılaştırıldı. Klinik başarı olarak tam taşsızlık ve <4 mm taş olması kabul edildi. Bulgular: Hastaların 163'ü 18-64 yaş aralığında, 83 tanesi ≥65 yaş idi. Gruplar arasında taş boyutu, operasyon süresi, floroskopi süresi, operasyon öncesi ve sonrası hemoglobin değeri farkı ve hastanede yatış süresinde istatistiksel fark saptanmadı (p=0,330, p=0,442, p=0,93, p=0,116 ve p=0,170 sırasıyla). Her iki grup arasında başarı oranı ve komplikasyon oranı benzer olarak saptandı (p=0,518 ve p=0,054 sırasıyla). Sonuç: Staghorn böbrek taşları için PCNL tedavisi yaşlı hastalarda ek hastalıklara rağmen güvenli ve etkin bir tedavi yöntemidir.

Anahtar Kelimeler: Perkütan nefrolitotomi; böbrek taşı; staghorn; yaşlı hasta
ABSTRACT
 Objective: In this study, we aimed to determine the efficacy and safety of percutaneous nephrolithotomy (PCNL) treatment for staghorn kidney stones in elderly patients. Material and Methods: The data of patients who underwent PCNL for staghorn kidney Stones in the Urology Clinic of Başkent University Adana Hospital between January 2011 and December 2021 were analyzed retrospectively. Patients with neuromuscular disease, renal anomaly, coagulopathy, skeletal deformity and solitary kidney were excluded from the study. The patients were divided into 2 groups as young and old; Group 1 (18-64 years), Group 2 (≥65 years). Young patients were considered as the control group. Stone size, operation time, fluoroscopy time, difference in hemoglobin value before and after the operation, length of hospital stay, complication and success rates were compared between the 2 groups. Complete stone-free and <4 mm stone were accepted as clinical success. Results: One hundred and sixty three patients were in the 18-64 age range, 83 patients were ≥65 years old. There were no significant differences between groups for stone area, operation time, floroscopy time, difference in hemoglobin levels before and after surgery and hospitalization time (p=0.330, p=0.442, p=0.93, p=0.116 and p=0.170 respectively). Also success rates and complication rates were similar in 2 groups (p=0.518 and p=0.054 respectively). Conclusion: PCNL treatment for staghorn kidney stones is a safe and effective treatment method in elderly patients despite additional comorbid diseases.

Keywords: Percutaneous nephrolithotomy; kidney stone; staghorn; aged patient
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