Multitrakt Percutaneous Nephrolithotripsy Versus Sandwich Therapy for Coralliform Kidney Stones

Objective: Percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) are performed in treatment of kidney stone disease for a long period beside the other treatment methods. Since 1987 PNL procedure has been used successfully and safely in our clinic for treatment of kidney...

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Main Authors: Huseyin Cihan DEMİREL, Cumhur YESİLDAL, Sinan Levent KİRECCİ, Kadir Cem GUNAY, Cagatay GOGUS
Format: Article
Language:English
Published: Ali İhsan Taşçı 2019-06-01
Series:Yeni Üroloji Dergisi
Subjects:
Online Access:https://dergipark.org.tr/tr/pub/yud/issue/46377/582475
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author Huseyin Cihan DEMİREL
Cumhur YESİLDAL
Sinan Levent KİRECCİ
Kadir Cem GUNAY
Cagatay GOGUS
author_facet Huseyin Cihan DEMİREL
Cumhur YESİLDAL
Sinan Levent KİRECCİ
Kadir Cem GUNAY
Cagatay GOGUS
author_sort Huseyin Cihan DEMİREL
collection DOAJ
description Objective: Percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) are performed in treatment of kidney stone disease for a long period beside the other treatment methods. Since 1987 PNL procedure has been used successfully and safely in our clinic for treatment of kidney stones. We aimed to compare the success rates of multitract access and sandwich therapies (PNL+SWL+PNL) in staghorn kidney stones performed in four years period. Materials and Method: During last four years 462 patients underwent PNL procedures in our clinic. 126 of the patients had staghorn kidney stones 23 of the patients (16male/7female) had multitract PNL while 16 (12male/4female) underwent sandwich therapy. We compare these two groups for postopertive early period and in 6th month success, major (bleeding and adjecent organ injury etc.) and minor (fever, urinary tract infections) complications, total hospitalization period, additional treatment requirements and total operation duration. Results: Statistically significant differences were appearent between two groups while total hospitalization period (9,74±3,19 days in multitract PNL group and 22,12±10,19 days in sandwich therapy group), total operation duration (110,78±35,57 minutes in multitract PNL group and 176,87±31,51 minutes in sandwich therapy group)(p<0,001) and blood replacement volumes (1,86±1,63 IU in multitract PNL group and 3,37±1,89 IU in sandwich therapy group) (p<0,05). The early postoperative period results (69,5% stone free rates, 17,4% ‘clinically insignificant residual fragments’ (CIRF) rates and 13,04% residual stone rates in in multitract PNL group and 62,5% stone free rates, 17,4% CIRF rates and 13,04% residual stone rates in days in sandwich therapy group) and in 6th month success findings were similar between two groups (p>0,05). Also additional treatment requirements, complication (major and minor) rates, stone analysis are compared and we did not find statistically significant differences between two groups (p>0,05). Conclusion: PNL is successfull and safe treatment method of staghorn stones. It can be performed with multitract technique in one session or with sandwich therapy technique which can be combined with SWL due to conditions. Besides the blood replacement volumes, hospitalization period and the ooperation, the comparison of these treatment modalities did not exhibit any significant differences for success and complication rates. Our outcomes are compatible with the literature.
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spelling doaj.art-748196a26298458f95f3e0baf02f62862023-02-15T16:07:56ZengAli İhsan TaşçıYeni Üroloji Dergisi1305-24892687-19552019-06-01142728010.33719/yud.582475Multitrakt Percutaneous Nephrolithotripsy Versus Sandwich Therapy for Coralliform Kidney StonesHuseyin Cihan DEMİREL0https://orcid.org/0000-0001-7378-5599Cumhur YESİLDAL1https://orcid.org/0000-0002-1518-8371Sinan Levent KİRECCİ2https://orcid.org/0000-0002-4734-4789Kadir Cem GUNAY3https://orcid.org/0000-0002-5780-7038Cagatay GOGUS4https://orcid.org/0000-0002-9710-7044Universty of Health and Science Sisli Hamidiye Etfal Training and Research HospitalUniversty of Health and Science Sisli Hamidiye Etfal Training and Research HospitalUniversty of Health and Science Sisli Hamidiye Etfal Training and Research HospitalUniversty of Health and Science Sisli Hamidiye Etfal Training and Research HospitalAnkara University School of MedicineObjective: Percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) are performed in treatment of kidney stone disease for a long period beside the other treatment methods. Since 1987 PNL procedure has been used successfully and safely in our clinic for treatment of kidney stones. We aimed to compare the success rates of multitract access and sandwich therapies (PNL+SWL+PNL) in staghorn kidney stones performed in four years period. Materials and Method: During last four years 462 patients underwent PNL procedures in our clinic. 126 of the patients had staghorn kidney stones 23 of the patients (16male/7female) had multitract PNL while 16 (12male/4female) underwent sandwich therapy. We compare these two groups for postopertive early period and in 6th month success, major (bleeding and adjecent organ injury etc.) and minor (fever, urinary tract infections) complications, total hospitalization period, additional treatment requirements and total operation duration. Results: Statistically significant differences were appearent between two groups while total hospitalization period (9,74±3,19 days in multitract PNL group and 22,12±10,19 days in sandwich therapy group), total operation duration (110,78±35,57 minutes in multitract PNL group and 176,87±31,51 minutes in sandwich therapy group)(p<0,001) and blood replacement volumes (1,86±1,63 IU in multitract PNL group and 3,37±1,89 IU in sandwich therapy group) (p<0,05). The early postoperative period results (69,5% stone free rates, 17,4% ‘clinically insignificant residual fragments’ (CIRF) rates and 13,04% residual stone rates in in multitract PNL group and 62,5% stone free rates, 17,4% CIRF rates and 13,04% residual stone rates in days in sandwich therapy group) and in 6th month success findings were similar between two groups (p>0,05). Also additional treatment requirements, complication (major and minor) rates, stone analysis are compared and we did not find statistically significant differences between two groups (p>0,05). Conclusion: PNL is successfull and safe treatment method of staghorn stones. It can be performed with multitract technique in one session or with sandwich therapy technique which can be combined with SWL due to conditions. Besides the blood replacement volumes, hospitalization period and the ooperation, the comparison of these treatment modalities did not exhibit any significant differences for success and complication rates. Our outcomes are compatible with the literature.https://dergipark.org.tr/tr/pub/yud/issue/46377/582475kidney stonepercutaneous nefrolitotomypnlsandwich therapyeswl
spellingShingle Huseyin Cihan DEMİREL
Cumhur YESİLDAL
Sinan Levent KİRECCİ
Kadir Cem GUNAY
Cagatay GOGUS
Multitrakt Percutaneous Nephrolithotripsy Versus Sandwich Therapy for Coralliform Kidney Stones
Yeni Üroloji Dergisi
kidney stone
percutaneous nefrolitotomy
pnl
sandwich therapy
eswl
title Multitrakt Percutaneous Nephrolithotripsy Versus Sandwich Therapy for Coralliform Kidney Stones
title_full Multitrakt Percutaneous Nephrolithotripsy Versus Sandwich Therapy for Coralliform Kidney Stones
title_fullStr Multitrakt Percutaneous Nephrolithotripsy Versus Sandwich Therapy for Coralliform Kidney Stones
title_full_unstemmed Multitrakt Percutaneous Nephrolithotripsy Versus Sandwich Therapy for Coralliform Kidney Stones
title_short Multitrakt Percutaneous Nephrolithotripsy Versus Sandwich Therapy for Coralliform Kidney Stones
title_sort multitrakt percutaneous nephrolithotripsy versus sandwich therapy for coralliform kidney stones
topic kidney stone
percutaneous nefrolitotomy
pnl
sandwich therapy
eswl
url https://dergipark.org.tr/tr/pub/yud/issue/46377/582475
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