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Publications (2)0 Total impact

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    ABSTRACT: Objective: The treatment of large proximal ureteral stones still remains controversial. We reviewed the antegrade percutaneous approaches for proximal ureteral stones in our clinic.Materials and methods: Forty-two percutaneous nephroureterolithotomy (PNUL) operations performed for proximal ureteral stones between February 2005 and January 2009 were included in the study. The stones were located between the ureteropelvic junction and 4th lumbar vertebra. PNULs were performed through the appropriate calix entry with the patients in prone position. During the operations, amplatz dilatators were used for dilatation and pneumatic lithotriptor was used for stone fragmentation. The patients were evaluated according to the success rate, complications, duration of hospitalization, duration of the operation, preference of drainage tube, etc. Results: The patients’ mean age was found to be 51 years, mean stone surface area 271 mm² and mean hospitalization time 1.78 days. Single access was performed in 41 patients and a second access was necessary in one patient. Finally, 39 (%92.8) patients became stone free. Nephrostomy tubes were placed in 8 patients after the operation while tubeless approach was preferred in 34 patients. Complications were seen in 4 patients. No late complications were encountered during the follow-up period. Conclusion: PNUL is an effective and safe treatment modality, when accessed through the appropriate calyx. The possibility of renal stone treatment in the same session is an important advantage of this modality.
    Turkish Journal of Urology. 01/2010;
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    ABSTRACT: Objective: Today, many surgical procedures can be performed under spinal anesthesia instead of general anesthesia. In this study, we compared the outcome of tubeless percutaneous nephrolithotomy performed under spinal anesthesia and general anesthesia.Materials and methods: Between December 2008 and March 2009, 21 patients with renal calculi were treated with tubeless percutaneous nephrolithotomy under spinal anesthesia. Patients at pediatric age group, cooperation difficulty during operation, and possibility of operation time over 2 hours were not given spinal anesthesia. The only exclusion criteria for tubeless percutaneous nephrolithotomy was clinically significant residuel fragments. The results of these patients and the results of 62 patients who underwent tubeless percutaneous nephrolithotomy under general anesthesia between January 2008 and August 2008 were matched for stone burden and age, and were compared. Two groups were identified regarding to anesthesia technique: spinal anesthesia (Group 1, n=21) and general anesthesia (Group 2, n=21). The groups were compared in terms of operation duration, postoperative hospital stay, analgesic requirement, hemoglobin drop, and stone-free rate.Results: Preoperative data and patient demographics were comparable between groups. There was no diffeence between groups in terms of stone-free rate, hospital stay, hemoglobin drop, and operation duration. However, the analgesic requirement was significantly higher in general anesthesia group than spinal anesthesia group (30.9 mg vs. 59.5 mg tramadol HCl, p=0.009).Conclusion: Tubeless percutaneous nephrolithotomy under spinal anesthesia is a feasible operation. Moreover, it has the advantage of less analgesic requirement postoperatively.
    Turkish Journal of Urology. 01/2010;