التفاصيل البيبلوغرافية
| العنوان: |
Retrograde Intrarenal Surgery in Children with Kidney Stones: Single Surgeon Experience. |
| Alternate Title: |
Böbrek Taşı Olan Çocuklarda Retrograd Intrarenal Cerrahi: Tek Cerrah Deneyimi. (Turkish) |
| المؤلفون: |
Cetin, Serhat, Tokat, Eda, Alishov, Sabuhi, Tan, Mustafa Ozgur, Gurocak, Ozdemir Serhat |
| المصدر: |
Gazi Medical Journal; 2022, Vol. 33 Issue 2, p125-128, 4p |
| مصطلحات موضوعية: |
KIDNEY stones, PEDIATRIC surgery, PERCUTANEOUS nephrolithotomy, KIDNEY surgery, URINARY tract infections, LENGTH of stay in hospitals |
| Abstract (English): |
Introduction: In the recent years, there has been a significant rise in paediatric stone disease population, hence with the advancement of technology, new minimally invasive treatment methods have been developed like percutaneous nephrolithotomy, retrograde intrarenal surgery (RIRS), shock-wave lithotripsy (SWL) and laparoscopic stone surgeries. Objective: In this study, we aimed to evaluate the data of paediatric RIRS cases performed by single surgeon in our clinic and to affirm the effectiveness and reliability of this method in treatment of kidney stones in children. Patients and Method: The data of 29 patients (13 boys and 16 girls) under 18 years of age who underwent RIRS due to kidney stones between April 2012 and September 2019 were analyzed retrospectively. All the operations were performed by the same surgeon. Urinary system x-ray, ultrasonography (USG) and non-contrast computed tomography (CT) scans were used to determine the urinary tract anatomy and stone characteristics. Results: The median age of 29 children was 8 (1-17) years. The mean stone diameter was determined as 11.4 ±0.875mm, 17(58.6%) patients had solitary stones and 12(41.4%) patients had multiple stones. In 7(24.1%) patients stones were situated in the renal pelvis, while 14(48.3%) were in lower calices and 8(%27.6) were in middle/upper calices. Ureteral access sheath was inserted in 11(38%) patients during the procedure, but not in the remaining 18(62%). The mean fluoroscopy time was 12±0.735sec. Double-J (DJ) stent was placed in all patients at the end of the procedure. The mean length of hospital stay was 1.2 days. The stone-free rate was 72.4% at the end of single session, 2(6.9%) patients received a second-look RIRS, and SWL was performed in 1(3.4%) patient postoperatively. Stone-free status was achieved in both patients after the second RIRS thus the final overall stone-free rate for RIRS was 79.3%. Postoperative febrile urinary tract infection developed in 1(3.4%) patient. Conclusion: RIRS is a minimally invasive treatment method in kidney stones that can be performed safely with high success rates in the paediatric age group within the appropriate indication. [ABSTRACT FROM AUTHOR] |
| Abstract (Turkish): |
Amaç: Son yıllarda pediatrik taş hastalığı popülasyonunda önemli bir artış olması nedeniyle teknolojinin de ilerlemesi ile perkütan nefrolitotomi, retrograd intrarenal cerrahi (RIRS), şok dalga litotripsi (SWL) ve laparoskopik taş ameliyatları gibi yeni minimal invaziv tedavi yöntemleri geliştirilmiştir. Bu çalışmada, kliniğimizde tek cerrah tarafından uygulanan pediatrik RIRS vakalarının verilerini değerlendirmeyi ve bu yöntemin çocuklarda böbrek taşı tedavisinde etkinliğini ve güvenilirliğini doğrulamayı amaçladık. Yöntem: Nisan 2012-Eylül 2019 tarihleri arasında böbrek taşı nedeniyle RIRS uygulanan 18 yaş altı 29 hastanın (13 erkek ve 16 kız) verileri retrospektif olarak incelendi. Tüm operasyonlar aynı cerrah tarafından yapıldı. İdrar yolu anatomisini ve taş özelliklerini belirlemek için direkt üriner sistem grafisi, ultrasonografi (USG) ve kontrastsız bilgisayarlı tomografi (BT) taramaları kullanıldı. Bulgular: 29 çocuğun ortanca yaşı 8 (1-17) idi. Ortalama taş çapı 11.4 ±0.875 mm olarak belirlendi, 17(%58.6) hastada tek, 12(%41.4) hastada multipl taş saptandı. Hastaların 7'sinde (%24.1) taş renal pelviste, 14'ünde (%48.3) alt kalikslerde, 8'inde (%27.6) orta/üst kalikslerdeydi. İşlem sırasında 11(%38) hastaya üreteral kılıf takılırken, kalan 18(%62) hastaya üreteral kılıfsız operasyon uygulandı. Ortalama floroskopi süresi 12±0.735sn idi. İşlem sonunda tüm hastalara Double-J (DJ) stent yerleştirildi. Ortalama hastanede kalış süresi 1.2 gündü. Tek seans sonunda taşsızlık oranı %72.4, 2(%6.9) hastaya ikinci seans RIRS, 1(%3.4) hastaya ameliyat sonrası rezidü taşlar için SWL uygulandı. İkinci seans RIRS'den sonra her iki hastada da taşsızlık durumu elde edildi, bu nedenle RIRS için nihai genel taşsızlık oranı %79.3 oldu. 1 (%3.4) hastada postoperatif ateşli idrar yolu enfeksiyonu gelişti. Sonuç: RIRS, böbrek taşı olan çocuk hastalarda uygun endikasyon dahilinde yüksek başarı oranları ile güvenle uygulanabilen minimal invaziv bir tedavi yöntemidir. [ABSTRACT FROM AUTHOR] |
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