On mm’ den küçük Proksimal Üreter Taşlarının Tedavisinde Fleksibl ve Semirijid Üreteroskopi Kullanımının Karşılaştırması
Abstract
Amaç: On mm
ve altındaki proksimal üreter taşlarında cerrahi gerektiren durumlarda fleksibl
üreteroskopi ve semirijid üreteroskopi kullanımı sonuçlarının ve
güvenilirliğinin değerlendirilmesi amaçlanmıştır.
Materyal ve Metod: Kliniğimizde
2013-2019 arasında 10 mm’ den küçük proksimal üreter taşı nedeniyle opere
edilen hastaların verileri retrospektif olarak değerlendirildi. Hastalar
cerrahide kullanılan üreteroskopi tipine göre fleksibl ve semirijid üreteroskopi
grubu olarak ikiye ayrıldı. Her iki grup demografik özellikler, operatif ve
postoperatif sonuçlar ve başarı oranları açısından karşılaştırıldı.
Bulgular: On
mm’den küçük proksimal üreter taşlarının cerrahisinde kullanılan üretroskopi
tipine göre, toplam 382 hastada fleksibl (266) ve semirijid (116) üreteroskopi
grupları arasında demografik özellikler ve taş boyutu arasında fark
bulunmamaktaydı. Ortalama operasyon süresi fleksibl üreteroskopi grubunda 45±10,9
dakika iken semirijid üreteroskopi grubunda 37.2±10.2 dakikaydı (p= 0.001).
Fleksibl üretroskopi grubunda %91,4 (266/243) ve semirijid üreteroskopi
grubunda %79,3 (116/92) başarı oranına ulaşıldı (p= 0.001). Komplikasyon
oranları açısından fleksibl (%10,5) ve semirijid (%16,4) üreteroskopi grupları
arasında fark yoktu.
Sonuç: Küçük
proksimal üreter taşlarında cerrahi gerektiren durumlarda fleksibl üreteroskopi
kullanımı yüksek başarı oranları ile semirijid üreteroskopi kullanımına göre
daha avantajlı gözükmektedir.
Keywords
Supporting Institution
Yok
References
- 1. Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck AC, Gallucci M, et al. 2007 Guideline for the management of ureteral calculi. Eur Urol. 2007;52(6):1610-31.2. Skolarikos A, Laguna MP, Alivizatos G, Kural AR, de la Rosette JJ. The role for active monitoring in urinary stones: a systematic review. J Endourol. 2010;24(6):923-30.3. Cui X, Ji F, Yan H, Ou TW, Jia CS, He XZ, et al. Comparison between extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy for treating large proximal ureteral stones: a meta-analysis. Urology. 2015;85(4):748-56.4. Salem HK. A prospective randomized study comparing shock wave lithotripsy and semirigid ureteroscopy for the management of proximal ureteral calculi. Urology. 2009;74(6):1216-21.5. Karadag MA, Demir A, Cecen K, Bagcioglu M, Kocaaslan R, Altunrende F. Flexible ureterorenoscopy versus semirigid ureteroscopy for the treatment of proximal ureteral stones: a retrospective comparative analysis of 124 patients. Urol J. 2014;11(5):1867-72.6. Galal EM, Anwar AZ, El-Bab TK, Abdelhamid AM. Retrospective comparative study of rigid and flexible ureteroscopy for treatment of proximal ureteral stones. Int Braz J Urol. 2016;42(5):967-72.7. Alkan E, Saribacak A, Ozkanli AO, Basar MM, Acar O, Balbay MD. Flexible Ureteroscopy Can Be More Efficacious in the Treatment of Proximal Ureteral Stones in Select Patients. Adv Urol. 2015;2015:416031.8. Frober R. Surgical anatomy of the ureter. BJU Int. 2007;100(4):949-65.9. Desai M, Sun Y, Buchholz N, Fuller A, Matsuda T, Matlaga B, et al. Treatment selection for urolithiasis: percutaneous nephrolithomy, ureteroscopy, shock wave lithotripsy, and active monitoring. World J Urol. 2017;35(9):1395-9.10. Cui Y, Cao W, Shen H, Xie J, Adams TS, Zhang Y, et al. Comparison of ESWL and ureteroscopic holmium laser lithotripsy in management of ureteral stones. PLoS One. 2014;9(2):e87634.11. Cone EB, Pareek G, Ursiny M, Eisner B. Cost-effectiveness comparison of ureteral calculi treated with ureteroscopic laser lithotripsy versus shockwave lithotripsy. World J Urol. 2017;35(1):161-6.12. Wu CF, Shee JJ, Lin WY, Lin CL, Chen CS. Comparison between extracorporeal shock wave lithotripsy and semirigid ureterorenoscope with holmium:YAG laser lithotripsy for treating large proximal ureteral stones. J Urol. 2004;172(5 Pt 1):1899-902.13. Lee YH, Tsai JY, Jiaan BP, Wu T, Yu CC. Prospective randomized trial comparing shock wave lithotripsy and ureteroscopic lithotripsy for management of large upper third ureteral stones. Urology. 2006;67(3):480-4; discussion 4.14. Huang CY, Chen SS, Chen LK. Cost-effectiveness of treating ureteral stones in a Taipei City Hospital: shock wave lithotripsy versus ureteroscopy plus lithoclast. Urol Int. 2009;83(4):410-5.15. Kumar A, Nanda B, Kumar N, Kumar R, Vasudeva P, Mohanty NK. A prospective randomized comparison between shockwave lithotripsy and semirigid ureteroscopy for upper ureteral stones <2 cm: a single center experience. J Endourol. 2015;29(1):47-51.16. Lam JS, Greene TD, Gupta M. Treatment of proximal ureteral calculi: holmium:YAG laser ureterolithotripsy versus extracorporeal shock wave lithotripsy. J Urol. 2002;167(5):1972-6.17. Volkin D, Shah O. Complications of ureteroscopy for stone disease. Minerva Urol Nefrol. 2016;68(6):570-85.18. Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol. 2016;69(3):475-82.19. Liu DY, He HC, Wang J, Tang Q, Zhou YF, Wang MW, et al. Ureteroscopic lithotripsy using holmium laser for 187 patients with proximal ureteral stones. Chin Med J (Engl). 2012;125(9):1542-6.20. Berardinelli F, De Francesco P, Marchioni M, Cera N, Proietti S, Hennessey D, et al. RIRS in the elderly: Is it feasible and safe? Int J Surg. 2017;42:147-51.21. K. Shigemura TY, M. Yamashita, S. Arakawa, and M., Fujisawa. Efficacy of combining flexible and rigid ureteroscopy for transurethral lithotripsy. Kobe Journal of Medical Sciences. 2010;56(1):E24-E8.
Comparison of Flexible and Semirigid Ureteroscopy Usage for Treatment of Smaller Than Ten Millimeter Proximal Ureteral Stones
Abstract
Background:In
this study, we aimed to investigate the treatment outcomes and safety profile
of flexible and semi-rigid ureteroscopy performed for the treatment of proximal
ureteral calculi smaller than 10 mm.
Materials and Methods: Patients
who underwent ureteroscopy in our clinic between 2013 and 2019 for proximal
ureteral stones smaller than 10 mm were assessed retrospectively. Patients were
divided into two groups with regard to ureteroscopy type. Each group were
compared in terms of demographic, operative and postoperative parameters and
success rates.
Results: No differences were
found between flexible (266) and semirigid ureteroscopy (116) groups in terms
of demographic features and stone sizes. Mean operative times were 45±10.9
minutes and 37.2±10.2 minutes for flexible and semi-rigid ureteroscopy groups,
respectively. Success rates were %91,4 (266/243) in flexible ureteroscopy group
and %79.3 (116/92) in semi-rigid ureteroscopy group. No differences were
detected in terms of complication rates (10.5% in flexible, 16.4% in semi-rigid
group).
Conclusion: Given
its high success rate, flexible ureteroscopy appears to be more advantageous
than semirigid ureteroscopy for treatment of proximal ureteral stone smaller
than 10 mm.
Keywords
References
- 1. Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck AC, Gallucci M, et al. 2007 Guideline for the management of ureteral calculi. Eur Urol. 2007;52(6):1610-31.2. Skolarikos A, Laguna MP, Alivizatos G, Kural AR, de la Rosette JJ. The role for active monitoring in urinary stones: a systematic review. J Endourol. 2010;24(6):923-30.3. Cui X, Ji F, Yan H, Ou TW, Jia CS, He XZ, et al. Comparison between extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy for treating large proximal ureteral stones: a meta-analysis. Urology. 2015;85(4):748-56.4. Salem HK. A prospective randomized study comparing shock wave lithotripsy and semirigid ureteroscopy for the management of proximal ureteral calculi. Urology. 2009;74(6):1216-21.5. Karadag MA, Demir A, Cecen K, Bagcioglu M, Kocaaslan R, Altunrende F. Flexible ureterorenoscopy versus semirigid ureteroscopy for the treatment of proximal ureteral stones: a retrospective comparative analysis of 124 patients. Urol J. 2014;11(5):1867-72.6. Galal EM, Anwar AZ, El-Bab TK, Abdelhamid AM. Retrospective comparative study of rigid and flexible ureteroscopy for treatment of proximal ureteral stones. Int Braz J Urol. 2016;42(5):967-72.7. Alkan E, Saribacak A, Ozkanli AO, Basar MM, Acar O, Balbay MD. Flexible Ureteroscopy Can Be More Efficacious in the Treatment of Proximal Ureteral Stones in Select Patients. Adv Urol. 2015;2015:416031.8. Frober R. Surgical anatomy of the ureter. BJU Int. 2007;100(4):949-65.9. Desai M, Sun Y, Buchholz N, Fuller A, Matsuda T, Matlaga B, et al. Treatment selection for urolithiasis: percutaneous nephrolithomy, ureteroscopy, shock wave lithotripsy, and active monitoring. World J Urol. 2017;35(9):1395-9.10. Cui Y, Cao W, Shen H, Xie J, Adams TS, Zhang Y, et al. Comparison of ESWL and ureteroscopic holmium laser lithotripsy in management of ureteral stones. PLoS One. 2014;9(2):e87634.11. Cone EB, Pareek G, Ursiny M, Eisner B. Cost-effectiveness comparison of ureteral calculi treated with ureteroscopic laser lithotripsy versus shockwave lithotripsy. World J Urol. 2017;35(1):161-6.12. Wu CF, Shee JJ, Lin WY, Lin CL, Chen CS. Comparison between extracorporeal shock wave lithotripsy and semirigid ureterorenoscope with holmium:YAG laser lithotripsy for treating large proximal ureteral stones. J Urol. 2004;172(5 Pt 1):1899-902.13. Lee YH, Tsai JY, Jiaan BP, Wu T, Yu CC. Prospective randomized trial comparing shock wave lithotripsy and ureteroscopic lithotripsy for management of large upper third ureteral stones. Urology. 2006;67(3):480-4; discussion 4.14. Huang CY, Chen SS, Chen LK. Cost-effectiveness of treating ureteral stones in a Taipei City Hospital: shock wave lithotripsy versus ureteroscopy plus lithoclast. Urol Int. 2009;83(4):410-5.15. Kumar A, Nanda B, Kumar N, Kumar R, Vasudeva P, Mohanty NK. A prospective randomized comparison between shockwave lithotripsy and semirigid ureteroscopy for upper ureteral stones <2 cm: a single center experience. J Endourol. 2015;29(1):47-51.16. Lam JS, Greene TD, Gupta M. Treatment of proximal ureteral calculi: holmium:YAG laser ureterolithotripsy versus extracorporeal shock wave lithotripsy. J Urol. 2002;167(5):1972-6.17. Volkin D, Shah O. Complications of ureteroscopy for stone disease. Minerva Urol Nefrol. 2016;68(6):570-85.18. Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol. 2016;69(3):475-82.19. Liu DY, He HC, Wang J, Tang Q, Zhou YF, Wang MW, et al. Ureteroscopic lithotripsy using holmium laser for 187 patients with proximal ureteral stones. Chin Med J (Engl). 2012;125(9):1542-6.20. Berardinelli F, De Francesco P, Marchioni M, Cera N, Proietti S, Hennessey D, et al. RIRS in the elderly: Is it feasible and safe? Int J Surg. 2017;42:147-51.21. K. Shigemura TY, M. Yamashita, S. Arakawa, and M., Fujisawa. Efficacy of combining flexible and rigid ureteroscopy for transurethral lithotripsy. Kobe Journal of Medical Sciences. 2010;56(1):E24-E8.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Article |
| Authors | |
| Publication Date | December 25, 2019 |
| Submission Date | August 8, 2019 |
| Acceptance Date | October 25, 2019 |
| Published in Issue | Year 2019 Volume: 16 Issue: 3 |
Harran Üniversitesi Tıp Fakültesi Dergisi / Journal of Harran University Medical Faculty