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Now showing 1 - 4 of 4
  • 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.
  • 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).
  • 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.