Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Retrograde Intrarenal Surgery Without JJ Stent Placement in Selected Cases of Renal Stones of 1 cm or Less Requirement of Ureteral Catheterization: Retrospective Observational Study
1 cm veya Daha Küçük Böbrek Taşları Seçilmiş Olgularında JJ Stent Yerleştirilmeden Yapılan Retrograd İntrarenal Cerrahi Üreteral Kateterizasyonun Gereksinimi: Retrospektif Gözlemsel Çalışma
Yasin YİTGİNa , Ayhan KARAKÖSEa
aDepatment of Urology, İstinye Universtiy Faculty of Medicine, İstanbul, Türkiye
J Reconstr Urol. 2023;13(1):16-21
doi: 10.5336/urology.2022-94198
Article Language: EN
Full Text
ABSTRACT
 Amaç: Bu çalışmanın amacı, 1 cm veya daha küçük böbrek taşlarının tedavisinde JJ stentsiz retrograd intrarenal cerrahinin (RİRC) güvenilirliğini, etkinliğini değerlendirmek, avantaj ve dezavantajlarını belirlemektir. Gereç ve Yöntemler: Bir cm veya daha küçük böbrek taşları nedeniyle komplike olmayan RİRC uygulanan 103 hastanın verileri retrospektif olarak incelendi. Üç grup oluşturuldu. RİRC işleminde 33 hastadan oluşan Grup 1'e JJ stent yerleştirilmedi, 36 hastadan oluşan Grup 2'ye açık uçlu üreteral stent yerleştirildi ve 34 hastadan oluşan Grup 3'e JJ stent yerleştirildi. Hastaların demografik verileri, taş karakterleri ile operatif ve postoperatif verileri analiz edildi. Tüm hastalarda postoperatif ağrı görsel analog skala [visual analog scale (VAS)] ile değerlendirildi. Bulgular: Demografik veriler ve taş özellikleri açısından gruplar arasında anlamlı fark yoktu. Postoperatif erken dönemde (ilk 24 saat) Grup 1'de VAS skorları anlamlı olarak yüksek iken, postoperatif 1. hafta kontrolünde Grup 3'te anlamlı olarak daha yüksek bulundu. Postoperatif erken dönemde rutin olmayan analjezik ilaç kullanımı diğer gruplara kıyasla Grup 1'de daha fazla hastada gerekti. Ameliyat sonrası ateşli idrar yolu enfeksiyonu açısından 3 grup arasında anlamlı fark yoktu. Sonuç: Postoperatif erken dönemde analjezi ihtiyacında artış olsa da seçilmiş olgularda JJ stent takılmadan da etkili ve güvenli RİRC'nin yapılabileceğini destekliyoruz. JJ stent semptomlarının olmadığı ve çıkarılması için ek bir müdahaleye gerek duyulmadığı unutulmamalıdır.

Keywords: Retrograde intrarenal surgery; ureteral catheterization; visual analogue scale; stent-related complaints
ÖZET
 Objective: To evaluate the safety, efficacy of without JJ stent of retrograde intrarenal surgery (RIRS) for the management of renal stones of 1 cm or less, and to determine the advantages and disadvantages. Material and Methods: The data of 103 patients who underwent uncomplicated RIRS for kidney stones of 1 cm or less were retrospectively analyzed. We formed 3 groups. Group 1 consisted of 33 patients were not placed JJ stent, Group 2 consisted of 36 patients were placed open-tip ureteral stent and Group 3 consisted of 34 patients were placed JJ stent in the RIRS procedure. Demographic data of patients and stone characters, as well as operative and postoperative data were analysed. Postoperative pain in all patients was evaluated using visual analog scale (VAS). Results: There were no significant differences between the groups for demographic data and stone characteristics. While the VAS scores were significantly higher in Group 1 in the early postoperative period (first 24 hours), a significant higher was found in Group 3 in the postoperative 1st week control. There were no significant difference between the 3 groups in terms postoperative febrile urinary tract infection. Conclusion: Although there may be an increase in the need for analgesia in the early postoperative period, we support that effective and safe RIRS can be performed without JJ stent placement in selected cases. It should be kept in mind that there are no JJ stent symptoms and no additional intervention is required for its removal.

Anahtar Kelimeler: Retrograd intrarenal cerrahi; üreter kateterizasyonu; görsel analog skala; stent ile ilgili şikâyetler
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