Retroperitoneal Fibrozis Tedavisi Deneyimi: Marmara Üniversitesi Üroloji ve Nefroloji Bölümlerinin 26 Yıllık Deneyimi

Abstract

BUlgUlAr: Hastaların beşi kadın, 15'i erkek; ortalama takip süresi 11,3 yıldı (1-18 yıl). Yirmi hastanın altısına unilateral, beşine bilateral, toplam 11 (%55) hastaya üreterolizis uygulandı. Tanı anındaki ortanca kreatinin değerleri kadınlarda 2,75 mg/dl (0,7 -6,9 mg/dl); erkeklerde 3,2 mg/dl (0,84 -7,2 mg/dl), tüm grupta ortanca 3,11 mg/dl (0,7 -7,2 mg/dl) olarak saptandı. Cerrahi (n=11) sonrası ortanca bazal kreatinin değeri 3,63 mg/dl'den (1,4-7,2 mg/dl) 1,46 mg/dl'ye (0,8 -2,6 mg/dl) geriledi. Cerrahi uygulanan ve uygulanmayan hastaların bazal kreatinin değerleri ve düşüşleri kıyaslandığında istatistiksel fark ortaya konulamamıştır. SOnUÇ:Retroperitoneal fibrosis nedeniyle uygulanan tedavi seçenekleri cerrahi ve farmakolojik tedaviler olmak üzere ikiye ayrılır. Çalışmamız, hastaların her iki tedavi yönteminden de benzer şekilde fayda gördüklerini göstermektedir. Tedavi seçimi her hastaya özel olmalıdır ve multidisipliner düzenlenmelidir.AnAhTAr SÖzcükler: Retroperitoneal fibrozis, Kreatinin, Üreterolizis, Tamoksifen ABSTrAcT OBJecTIVe: Retroperitoneal fibrosis (RPF) is a rare condition characterized by the presence of inflammation and fibrosis in the retroperitoneum. This study describes our multidisciplinary approach and our results. MATerIAl and MeThOdS:Patients diagnosed with RPF at Marmara University between January 1990 and May 2007 were evaluated. Etiologies, demographic characteristics, renal functions, treatments and prognoses of each patient were recorded and data were analyzed. reSUlTS: Of all patients, five were female, 15 were male and the mean follow-up was 11.3 years (1 -18 years). Six patients were operated unilaterally and five were operated bilaterally with ureterolysis.Median creatinine values at diagnosis were 2.75 mg/dl (0.7-6.9 mg/dl) in females, 3.2 mg/dl (0.84-7.2 mg/dl) in males and 3.11 mg/dl (0.7 -7.2 mg/dl) in the whole group. Median baseline creatinine level after surgery (n=11) was found to decrease from 3.63 mg/dl (1.4-7.2 mg/dl) to 1.46 mg/dl (0.8-2.6 mg/dl). Baseline and drop in creatinine were compared among patients treated with either surgical or pharmacological methods, and no statistical significance was found.cOnclUSIOn: Retroperitoneal fibrosis can be treated surgically and pharmacologically. Our study has shown similar success for both methods. Treatment should be specific for each patient in a multidisciplinary fashion.