Engin KÖLÜKÇÜ, Bekir Süha PARLAKTAŞ, Şahin KILIÇ, Fikret ERDEMİR, Yahya DOĞANAY

Unutulan Double-J Stentlere Bağlı Gelişen Stent Enkrustasyonlarının Tedavisinde Holmium Lazer Litotripsinin Etkinliği

Amaç: Çalışmamızda unutulan D-J stentlere bağlı gelişen stent enkrustasyonu tespit edilen 14 hastaya uyguladığımız üreterorenoskopik holmiyum lazer litotripsi sonuçlarını sunmayı hedefledik.Gereç ve Yöntem: Ocak 2015-Mayıs 2017 yılları arasında unutulan D-J stent enkrustasyonu nedeniyle holmiyumlazer litotripsi uygulunan 14 hastanın verileri retrospektif olarak incelendi. Çalışmaya alınan hastaların yaşı, hastaneye başvuru şikayetleri, üreteral stentlerin kalış süreleri, enkrustasyon boyutu, yerleşimi, operasyon süreleri ve modifiye Clavien sınıflamasına göre komplikasyonları değerlendirildi.Bulgular: Hastaların ortalama yaşı 59.41±5.23 yıl idi. 3 hasta idrarda kanama, 2 hasta sık idrara çıkma ve urge inkontinans gibi alt üriner sistem yakınması ile, 5 hasta yan ağrısı, 1 hasta idrarda kanama ile birlikte olan yan ağrısı, 1 hasta idrar yolu enfeksiyonu ve 2 hasta ise idrarda kanama ile birlikte olan alt üriner sistem yakınması ile kliniğimize başvurdu.Stentlerin ortalama kalış süreleri 20.5±6.11 aydı. Ortalama enkrustasyon boyutu 311±43 mm2 idi.Hastaların 11’inde distal ve 3’ünde ise proksimal stent enkrustasyonu izlendi. Ortalama operasyon süresi 63.12±9.48 dakika olarak hesaplandı. Modifiye Clavien sınıflamasına göre operasyon komplikasyonları değerlendirildi.2 hastada 1. düzeyde, 1 hastada 2. düzeyde ve 1 hastada ise 3a düzeyinde komplikasyon izlendi.Sonuç: Çalışmamızda elde edilen verilere göre; unutulan üreteral stentlere bağlı oluşan stent enkrustasyonlarının tedavisinde üreterorenoskopik holmiyum lazer litotripsi kulanımının etkin ve güvenilir bir yöntem olduğu sonucuna varılmıştır.

Anahtar Kelimeler:

Double-J stent, enkrustasyon, holmiyum lazer litotripsi

Effectiveness of Holmium Laser Lithotripsy Treatment on Forgotten Double-J Stents With Encrustations

Aim: In our study, we aimed to present the results of ureterorenoscopic holmium laser lithotripsy treatment on 14 forgoten double-j stents with encrustations.Material and Methods: The data of 14 patients who underwent holmium laser lithotripsy treatment for forgotten D-J stent encrustations between January 2015 and May 2017 were reviewed retrospectively. The patients' age, symptoms, length of stay of ureteral stents, size of encrustations, locations, duration of operation and complications according to modified Clavien classification were evaluated.Results: The mean age of the patients was 59.41 ± 5.23 years. 2 patients admitted to our clinic with lower urinary tract complaints such as frequent urination, urinary incontinence, 5 patients admitted with side pain, 3 patients admitted with hematuria, 1 patient admitted with hematuria and side pain, 1 patient admitted with urinary tract infection and 2 patients admitted with lower urinary tract complaints and hematuria. The mean length of stay of stents was 20.5 ± 6.11 months. The mean size of the encrustations was 311±43 mm2. Operation complications were evaluated according to modified Clavien classification. Proximal stent encrustation was observed in 3 patients and distal in 11 patients. The mean duration of operation was calculated as 63.12 ± 9.48 minutes. Complications were observed in 1.level in 2 patient, 2. level in 1 patient and 3a level in 1 patient.Conclusion: According to the results obtained in our study; the use of ureterorenoscopic holmium laser lithotripsy is an effective and reliable method for the treatment of forgotten double-J stents with encrustations.

Keywords:

Double-J stent, encrustations, holmium laser lithotripsy,

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