Endoüroloji Bülteni

Yazarlar: Doğukan SÖKMEN, Yusuf İ̇lker ÇÖMEZ, Volkan TUĞCU

Konular:Üroloji ve Nefroloji

Anahtar Kelimeler:Kidney stones,GSS,Clavien,Percutaneous nephrolithotomy,Complications,Stone-free

Özet: Objective: Urinary system stone disease has been one of the leading diseases that negatively affect human life and quality of life throughout history. Our aim is to present the percutaneous nephrolithotomy experience of three centers in our country in all aspects (patient selection, success, additional treatment requirement, complications, mortality) and to shed light on future studies. Material And Methods: Classical PNL and miniPNL with full records; The data of 944 patients from 3 centers were evaluated retrospectively. Kidney stones were classified using the Guy Stone Scoring system (Guy’s Stone Score, GSS) based on stone burden and localization. Clavien classification, modified by them in 2004, was used for per-operative and post-operative complications in patients. In statistical analysis; success, the need for additional treatment, the effect of complications on complications and percentage rates were compared using the chi-square test, and p <0.05 was considered statistically significant. Independent factors affecting success, complications, and additional treatment were determined using logistic regression analysis. Results: In 662 of our 944 patients (70.13%), success was achieved in direct urinary system radiography and / or non-contrast abdominal CT taken on the first postoperative day without any rest stones. After additional treatment applied to 23.30% of the patients, this rate increased to 83.65% in the postoperative 6th month. The success rate for stones in the GSS 1 group was 90.06% and was quite high. This ratio was statistically significant compared to the GSS 3 and GSS 4 groups (p <0.001). The success rate increases significantly in groups with low GSS scores. A total of 478 complications were observed in 435 (46.08%) of 944 patients operated on. When we arrange these data according to the modified Clavien grading system, 159 (16.84%) in grade 1, 152 (16.10%) in grade 2, 113 (11.97%) in grade 3a, 15 in grade 3b ( 1.58%), 9 (0.95%) in grade 4a, 1 (0.10%) in grade 4b, and 1 (0.10%) in grade 5 were observed. When the distribution of complications by stone groups was examined, it was observed that all grade 4a, 4b, and grade 5 complications were seen in GSS 4 group stones. Conclusion: The complex classification of kidney stones can be eliminated using the “Guy Stone Score”. It is categorized in a simple way and the probabilities of success and complications are predicted. Complications can be standardized using the “Modified Clavien Grading”. In addition, the classifications shed light on clinical research and studies.

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