Our initial experiences in Micro Percutaneous Nephrolithotomy

Abstract

GirişBöbrek taşı tedavisinde gelişen komplikasyon oranlarını azaltmak için klasik perkütan nefrolitotomi (PNL) prosederünü takiben akses traktı daha küçük olan mini ve ultra-mini-PNL yöntemleri geliştirilmiştir (1,2).Mikro-PNL ise daha az invaziv, tek basamakta akses yapılan ve akses traktı daha küçük olan bir işlemdir (3,4). Mikro-PNL'nin en önemli avantajı kanamanın az olması ve komşu organ yaralanması riskinin az olmasıdır (5,6). Mikroperkütan nefrolitotomi, küçük ve orta büyüklükteki seçilmiş olgulara önerilmektedir (7). Sonuç:Mikroperkütan nefrolitotomi, düşük-orta büyüklükteki böbrek taşlarının tedavisinde güvenli ve etkin bir tedavi yöntemidir. Anahtar Kelimeler: Böbrek taşı, tedavi, mikro-perkütan nefrolitotomi ABSTRACTObjective: We aimed to evaluate our initial micropercutaneous nephrolithotomy (micro-PNL) experiences. Materaials and Methods:In this study the results of 10 patients who underwent micro-PNL for renal stones between August 2014 and January 2015 in Yüzüncü Yıl University were evaluated. All interventions were performed in the prone position under general anesthesia. In all patients 4.85 F all-seeing needle was used. The stones were fragmented using [8 Hz (6.4 W) 0.8 J] 200 lm or 270 lm Ho: YAG laser fiber under direct visualization. The procedure was terminated with no need of any nephrostomy tube. Stone-free rates 1 day and 1 month postoperatively were assessed by US, and KUB. The patients were evaluated by CT when thought residue stone. Results:The mean age of patients in this study was 26.7 ± 20.6 (3-43) years, and the mean stone size was 13.1 ± 5.15 (0.9-22) mm and the mean operation duration was 38 (24-58) min. The mean hospital stay was 1.76 ± 0.65 (1-5) days, and the mean drop in the hemoglobin level was 0.82 ± 0.84 (0-1.3) mg/dL. None of our patients required transfusion. Ureteral J stent was implanted in 4 (40%) patients. One (10 %) patient complained of postoperative renal colic and abdominal distension was observed in one patients (10 %) who was 3 years old. They were treated conservatively. Also postoperative fever was seen in only one patient. In one patient residue stone was detected by CT. Conclusions:Micro-PNL is a safe and effective treatment method for small and moderately sized kidney stones.