Have the Technological Advancements Changed the Distribution of Treatment Modalities for Urolithiasis?

Abstract

A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : The aim of this study was to assess the current practice patterns and the distribution of treatment modalities in treatment of urolithiasis. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A retrospective study was conducted on the patients who underwent procedures for stone removal or fragmentation in 6 centers in İstanbul, between January 1, 2008 and December 31, 2009. Hospital and office charts, operative notes and records, and pertinent radiographic studies of all patients were reviewed. Patient characteristics, treatment modalities, lithotripter use, stone localization and the side were documented for each patient. R Re es su ul lt ts s: : Of 1756 procedures, the majority was endoscopic surgery (80.7%, n=1417), while 21.6% (n=379) of the patients had percutaneous nephrolithotomy, 47.3% (n=831) had semirigid ureteroscopy, 7.6% (n=134) had cystolithotripsy, 2.2% (n=38) had retrograde intrarenal surgery, 1.4% (n=24) had flexible ureteroscopy, 0.3% (n=6) had laparoscopic ureterolithotomy, and 0.1% (n=2) had laparoscopic pyelolithotomy. Open stone surgery rate was 19.3% (n=339) which included pyelolithotomy (8.5%, n=150), ureterolithotomy (4.7%, n=82), cystolithotomy (2.4%, n=43), nephrolithotomy (2.2%, n=39), pyelonephrolithotomy (0.7%, n=13), anatrophic nephrolithotomy (0.5%, n=8), pyeloplasty (0.3%, n=5) and nephrectomy (0.1%, n=2). There were 1276 (72.7%) males and 480 (27.3%) females between the ages of 3-85 years (mean age 45.5±15.8 years). C Co on nc cl lu us si io on n: : Although the advent of percutaneous nephrolithotomy and ureteroscopy in combination with lithotripsy technique has dramatically altered the management of renal and ureteral stones, open stone surgery maintains a small but continued role in the treatment of patients with renal and ureteral calculi. K Ke ey y W Wo or rd ds s: : Lit hot ripsy; uro lit hi a sis; uro lo gic sur gi cal pro ce du res Ö ÖZ ZE ET T A Am ma aç ç: : Bu ça lış ma nın ama cı ürolitiyazis te da vi sin de uy gu la nan te da vi mo da li te le ri nin gün-cel pra ti ği miz de ki da ğı lı mı nı or ta ya koy mak tır. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : 1 Ocak 2008 ile 31 Ara lık 2009 ta rih le ri ara sın da İstan bul' da ki 6 mer kez de uy gu la nan taş cer ra hi pro se dür le ri ret ros pek tif ola rak de ğer len di ril di. Has ta la ra ait dos ya, ame li yat ka yıt la rı ve rad yo lo jik tet kik le ri in ce len di. Hasta la rın özel lik le ri, te da vi mo da li te le ri, lit hot rip tör kul la nı mı ve taş lo ka li zas yo nu her has ta için kayıt edil di. B Bu ul l g gu u l la ar r: : Uy gu la nan top lam 1756 cer ra hi pro se dü rün ço ğun lu ğu nu en dos ko pik cer ra hi gi ri şim (n=1417, %80,7) oluş tur mak tay dı (per kü tan nef ro li to to mi: n=379, %21,6; se mi ri gid üre teros ko pi: n=831, %47,3; sis to li tot rip si: n=134, %7,6; ret rog rad-in tra re nal cer ra hi: n=38, %2,2; fleksib le üre te ros ko pi: n=24, %1,4; la pa ros ko pik üre te ro li to to mi: n=6, %0,3; ...