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AKÇAY, MUZAFFER

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MUZAFFER
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AKÇAY
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Has files: true × Author: Tepeler, Abdulkadir × Author: TOSUN, MUHAMMED ×

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    PublicationOpen Access
    Comparison of Scoring Systems in Predicting Success of Percutaneous Nephrolithotomy
    (2019-01-01T00:00:00Z) AKÇAY, MUZAFFER; Tosun, Muhammed; GEVHER, FATİH; KALKAN, Senad; ERSÖZ, CEVPER; Kayali, Yunus; Tepeler, Abdulkadir; AKÇAY, MUZAFFER; TOSUN, MUHAMMED; GEVHER, FATİH; KALKAN, SENAD; ERSÖZ, CEVPER; KAYALI, YUNUS
    Background: Scoring systems are useful to inform the patients about the success and complication rates of the operation prior the surgery. Aims: To determine the applicability of the popular scoring systems (Guy’s, stone size, tract length, obstruction, number of involved calices, and essence/stone density and Clinical Research Office of the Endourological Society) by means of examining preoperative data of patients treated with percutaneous nephrolithotomy. Study Design: Cross sectional study. Methods: We retrospectively reviewed files of the patients who had undergone percutaneous nephrolithotomy in our center between 2011 and 2015. Excluded from the study were patients aged <18 years, and those who were not assessed preoperatively with computed tomography. Preoperative computed tomography images of all patients were assessed by a single observer, and patients were graded based on three scoring system. Demographic data were analyzed along with perioperative data (operation, fluoroscopy, length of hospital stay, changes in hematocrit values, location, and number of access sites, stone-free and complication rates). Results: A total of 298 patients who had been treated with 300 procedures were enrolled into the study. Mean age, stone burden, number of stones, and density were 48.1±12.9 years, 663.5±442.8 mm2, 1.8±1.1 and 888.3±273 HU respectively. Scores of the cases based on Guy’s, stone size, tract length, obstruction, number of involved calices, and essence/stone density, and Clinical Research Office of the Endourological Society scoring system were calculated as 2, 7.6, and 222.1 points respectively. 81.6% of the patients were stonefree. Complications were detected in 30 (9.9%) patients. Based on receiver operating characteristic curve analysis a positive correlation was detected between success rate and scoring systems, i.e., Guy’s (p=<0.001, r=-0.309), stone size, tract length, obstruction, number of involved calices, and essence/stone density (p=<0.001, r=-0.295), and Clinical Research Office of the Endourological Society (p=<0.001, r=0.426). The Clinical Research Office of the Endourological Society scoring system had the highest predictive value. The sensitivity rates rates for Guy’s, Clinical Research Office of the Endourological Society and Stone scoring system were as 78.78%, 80% and 82.34% respectively. Conclusion: All of scoring systems predicted correctly the success of the percutaneous nephrolithotomy procedures. The Clinical Research Office of the Endourological Society scoring system had the highest predictive value. Keywords: Percutaneous nephrolitotomy, scoring methods, specificity and sensitivity, urinary calculi
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    PublicationOpen Access
    Current Minimal Invasive Surgery Treatment For Kidney Stones: Bezmialem Experience
    (2016-08-01T00:00:00Z) AKÇAY, MUZAFFER; Tepeler, Abdulkadir; TOSUN, MUHAMMED; Basibuyuk, Ismail; Elbir, Fatih; KARDAŞ, SİNA; Akman, Tolga; Armagan, Abdullah; Tasci, Ali Ihsan; AKÇAY, MUZAFFER; TOSUN, MUHAMMED; KARDAŞ, SİNA
    Objective: We aimed to present the outcomes of patients with symptomatic kidney stones treated with percutaneous nephrolithotomy (PNL) or retrograde intrarenal surgery (RIRS). Methods: The medical records of patients with symptomatic renal calculi treated with PNL or RIRS between November 2010 and May 2015 were obtained. Demographic characteristics such as age; sex; BMI; stone size and location; and perioperative data including operation, fluoroscopy, and hospitalization time; and success and complication rates were assessed. Results: Standard (n:336), mini-PNL (n:51), ultramini-PNL (n:37) and microperc (n:47) were performed for 471 renal units. RIRS was the treatment method for 290 renal unites. In the PNL group, the mean patient age was 44.5 (1-83) years and BMI was 26.9 kg/m2. The mean stone size was 27.6 mm. In the RIRS group, the mean age and BMI were 47.1 (1-86) years and 25.1 kg/m2, respectively. The mean operation, fluoroscopy, and hospitalization times were 70.0 (20-240) min, 45.1 (17-610) s, and 2.4 (1-20) days, respectively, in the PNL group. On the other hand, the mean operation, fluoroscopy, and hospitalization times were 62.5 (40-180) min, 29.8 (0-96) s, and 26.4 (12-120) h, respectively, in the RIRS group. Whine stone free status was achieved in 88% in the PNL group; this rate was lower (80%) in the RIRS group. Conclusion: Both PNL and RIRS are efficient minimally invasive methods with low morbidity and high success rates for the treatment of symptomatic kidney stone disease.