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Now showing 1 - 10 of 10
  • PublicationOpen Access
    Flexible ureterorenoscopy results: analysis of 279 cases
    (2015-09-01T00:00:00Z) Elbir, Fatih; Basibuyuk, Ismail; Topaktas, Ramazan; KARDAŞ, SİNA; TOSUN, MUHAMMED; Tepeler, Abdulkadir; Armagan, Abdullah; KARDAŞ, SİNA; TOSUN, MUHAMMED
    Objective: In this study, the outcomes of 279 cases in whom we performed retrograde intrarenal surgery (RIRS) were evaluated retrospectively. Material and methods: RIRS was performed on 279 cases with the aid of access sheath of guidewire between March 2011 and February 2015. All patients were operated in the standard lithotomy position. A hydrophilic guidewire was inserted with the aid of rigid ureterorenoscopy and we checked whether there were any residual ureteral stones and other pathologies. Fluoroscopy was used routinely in all cases. Stone fragments smaller than 3 mm were left off but those bigger than 3 mm were removed by grasper after stone fragmentation. Controls of the patients were assessed by plain films (KUB), urinary tract ultrasonography (US) and/or computed tomography (CT) 1 month after the operation. Success rate of the procedure was defined as the stone-free status or presence of residual fragments less than 3 mm. Results: 152 of the patients were male and 127 were female. The median ages of the male and female patients were 47.7 (1-86) ve 45.9 (3-79) years respectively. The median stone size was 13.5 mm (8-25). Preoperatively 34 (12.1%) patients had double-J ureteral stent. 19 (6.8%) patients were operated while they were still receiving antithrombotic and antiplatelet therapy Solitary kidney was present in 24 patients while the remaining patients had kyphoscoliosis (n=3), rotation anomaly (n=6), pelvic kidney (n=2), double collecting system (n=3), and horseshoe kidney (n=6). In 264 patients access sheath was used, in 15 patients operation was performed with the help of the guidewire. Double-J stents were inserted to 14 patients because of ureteral stricture and they underwent operation after 2 weeks later. Renal stones of 219 patients among all cases were fragmented completely and the patients were discharged as stone free (SF). Our success rate (SF or presence of clinically insignificant residual [CIRF]) was 78.4%. Stone size (p=0.029), stone number (p=0.01), stone location (p=0.023) had significant influence on the stone-free rate after RIRS The mean operation and floroscopy time was 62.5 min. (40-180) and 29.8 sec (4-96), respectively. The mean hospitalization time was 26.4 hours (12-72). Double J stents were placed to 253 patients for more stone burden and ureteral edema. Any complication was not observed for all cases except perioperative developed infection for two patients. Conclusion: With advances in laser technology and flexible ureterorenoscopy, kidney stones can be treated with lower morbidity and high success rates. Keywords: Flexible ureterorenoscopy; kidney stone; retrograde intrarenal surgery.
  • PublicationMetadata only
    Do the urolithiasis scoring systems predict the success of percutaneous nephrolithotomy in cases with anatomical abnormalities?
    (2017-06-01T00:00:00Z) Kocaaslan, Ramazan; Tepeler, Abdulkadir; Buldu, Ibrahim; TOSUN, MUHAMMED; Utangac, Mehmet Mazhar; Karakan, Tolga; Ozyuvali, Ekrem; Hatipoglu, Namik Kemal; ÜNSAL, ALİ; Sarica, Kemal; TOSUN, MUHAMMED
    The objective of this study is to assess the utility of the Guy, S.T.O.N.E., and CROES nephrolithometry scoring systems (SS), and compare the capability of each system to predict percutaneous nephrolithotomy (PNL) outcome in patients with anatomical abnormalities. We retrospectively collected medical records of patients with anatomical abnormalities who underwent PNL for the treatment of renal calculi by experienced surgical teams in four referral centers. All of the patients were graded by a single observer from each department based on preoperative computed tomography images using each SS. Patient demographics and outcomes were compared according to the complexity of the procedure as graded by each scoring system. A total of 137 cases with anatomical abnormalities [horseshoe kidney (n = 46), malrotation (n = 33), kypho and/or scoliosis (n = 31) and ectopic kidney (n = 27)] were assessed retrospectively. The mean stone burden, number, and density were 708.5 mm(2), 1.7, and 791.8 HU, respectively. The mean procedure, fluoroscopy, and hospitalization times were 75.2 +/- 35.3 min, 133.4 +/- 92.3 s, and 3.5 +/- 2.1 days, respectively. Stone-free status was achieved in 106 cases (77.4 %). A total of 17 (13.6 %) complications occurred postoperatively. The mean scores were 2.7, 7.2, and 219.1, for the Guy, S.T.O.N.E., and CROES systems, respectively. CROES score was the independent predictor of PNL success in cases with anatomical abnormalities [p: 0.001, OR 1.01, (95 % CI 1005-1021)]. The CROES scoring system is well correlated with the success of PNL in cases with anatomical abnormalities; the S.T.O.N.E. and Guy scoring systems failed to predict the outcomes of PNL in this specific patient population.
  • PublicationOpen Access
    Comparison of Scoring Systems in Predicting Success of Percutaneous Nephrolithotomy
    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
  • PublicationMetadata only
    Comparison of Anesthesia Methods in Treatment of Staghorn Kidney Stones with Percutaneous Nephrolithotomy
    (2016-01-01T00:00:00Z) Buldu, Ibrahim; Tepeler, Abdulkadir; KAYNAR, MEHMET; Karatag, Tuna; TOSUN, MUHAMMED; Umutoglu, Tarik; Tanriover, Hakan; Istanbulluoglu, Okan; TOSUN, MUHAMMED
    Purpose: To compare the efficacy and safety of percutaneous nephrolithotomy (PNL) in the treatment of staghorn calculi (SC) under spinal anesthesia (SA) versus general anesthesia (GA).
  • PublicationMetadata only
    Comparison of flexible ureterorenoscopy and micropercutaneous nephrolithotomy in the treatment for moderately size lower-pole stones
    (2015-11-01T00:00:00Z) Armagan, Abdullah; Karatag, Tuna; Buldu, Ibrahim; TOSUN, MUHAMMED; Basibuyuk, Ismail; Istanbulluoglu, Mustafa Okan; Tepeler, Abdulkadir; TOSUN, MUHAMMED
    To present a retrospective comparative clinical study of micropercutaneous nephrolithotomy (microperc) versus flexible ureterorenoscopy (F-URS) in treatment of moderate-size lower-pole stones (LPSs).
  • PublicationOpen Access
    Removal of a retroperitoneal foreign body through single port laparoscopy using nephroscope
    (2017-09-01T00:00:00Z) Basibuyuk, Ismail; Tosun, Muhammed; KALKAN, Senad; Tepeler, Abdulkadir; TOSUN, MUHAMMED; KALKAN, SENAD
    Foreign bodies are rare and challenging issues leading to symptoms according to the location. Laparoscopy is a popular and minimally invasive method used for removal of foreign bodies in the abdominal cavity or retroperitoneum. We herein report a case with retroperitoneal foreign body that was removed through retroperitoneal single- port laparoscopy using nephroscope. To our knowledge this is the first case of removal of a retroperitoneal foreign body through single- port laparoscopy using nephroscope.
  • PublicationMetadata only
    Comparison of Scoring Systems in Pediatric Mini-Percutaneous Nephrolithotomy
    (2016-07-01T00:00:00Z) Utangac, Mehmet Mazhar; Tepeler, Abdulkadir; Daggulli, Mansur; Tosun, Muhammed; Dede, Onur; Armagan, Abdullah; TOSUN, MUHAMMED
    OBJECTIVE To apply urolithiasis scoring systems to the pediatric miniperc procedure and to compare their predictive capability for postoperative outcomes.
  • PublicationMetadata only
    The role of ultra-mini percutaneous nephrolithotomy in the treatment of kidney stones
    (2016-12-01T00:00:00Z) Tepeler, Abdulkadir; Basibuyuk, Ismail; TOSUN, MUHAMMED; Armagan, Abdullah; TOSUN, MUHAMMED
    Objective: In our study we aimed to evaluate outcomes of ultra-mini-percutaneous nephrolithotomy (UMP) performed for the treatment of kidney stones.
  • PublicationMetadata only
    Is micro-percutaneous nephrolithotomy surgery technically feasible and efficient under spinal anesthesia?
    (2015-06-01T00:00:00Z) Karatag, Tuna; Tepeler, Abdulkadir; Buldu, Ibrahim; AKÇAY, MUZAFFER; TOSUN, MUHAMMED; Istanbulluoglu, Mustafa Okan; Armagan, Abdullah; AKÇAY, MUZAFFER; TOSUN, MUHAMMED
    The objective of the study was to present the clinical and operative effects of two types of anesthesia on micro-percutaneous nephrolithotomy (-microperc-). We retrospectively reviewed 116 patients who underwent microperc between August 2011 and September 2013. Patients were sorted into one of the two groups according to the type of anesthesia received: general (Group 1, n:53) or spinal (Group 2, n:63). Perioperative variables (age, stone size, location) and outcomes (operation time, success, complication rate) were evaluated and compared. Although there was a statistically significant difference in the mean age of patients (30.3 +/- A 22.1 vs. 45.8 +/- A 14.6, respectively, p < 0.001), mean body mass indexes were similar (p = 0.689). There was no substantial difference in terms of sizes and localizations of stones in the two groups (p = 0.970 and p = 0.795). While a significant difference was found in comparison of operative times (59.62 +/- A 32.56 vs. 40.98 +/- A 26.45 min, p < 0.001), there was no statistically significant difference in mean fluoroscopy times (124.92 +/- A 84.2 vs. 105.2 +/- A 61.0 s, p = 0.441). Stone-free rates were similar (90.5 % vs. 93.6 %, p = 0.297). We found no statistical differences between the two groups with respect to mean hemoglobin drop and hospitalization time (p = 0.015 and p = 0.917, respectively). The complication rates and analog pain scores were also similar (p = 0.543 and p = 0.365). Our results show that microperc is a feasible surgical modality in the treatment of kidney stone disease under both spinal and general anesthesia. Spinal anesthesia may be considered for patients at a high risk for general anesthesia, and also may be an alternative for patients who are concerned about and/or fearful of general anesthesia.
  • 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.