Akademik Veri Yönetim Sistemi
JOURNAL OF CLINICAL AND ANALYTICAL MEDICINE, cilt.6, ss.53-57, 2015 (ESCI, TRDizin)
Aim: In this study, we aimed to compare the success and complication rates of intercostal and subcostal aproaches in percutaneous nephrolithotomy which is applied for renal stones in different locations and upper ureteral stones. Material and Method: We record retrospectively of 378 patients operated at Izmir Bozyaka Training and Research Hospital Department of Urology between January 2011-January 2015 for renal stones in different locations and upper ureteral stones. The patients were divided into two different groups according to access site. Group 1 consists of 228 patients with subcostal access and group 2 consists of 150 patients with intercostal access. Results: Mean ages of group 1 and group 2 were 48.65 +/- 12.87 and 48.57 +/- 12.91 respectively (p=0.949). Mean stone burden was not statistically significiant between the groups. Mean stone burden of group 1 and group 2 were 788.6 +/- 475.47 mm2 and 657.5 +/- 469.63 mm2 respectively (p= 0.081). Mean operative time was statistically significant between the groups (p= 0.042). Mean operative time was 113.84 +/- 41.34 min. in group 1 and 105.07 +/- 40.30 min. in group 2. Scopy times were 92.38 +/- 58.06 sec. in group 1 and 95.51 +/- 70.06 sec in group 2 (p= 0.637). At the post-operative first day heamothocrit loss was 1.81 +/- 1.25 g/dl and 1.62 +/- 1.34 g/dl for groups 1 and 2 respectively (p=0.175). Residual fragmants were detected in 47 and 29 patients for groups 1 and 2 respectively (p= 0.761). Duration of hospitalization was 4.16 +/- 2.68 days and 4.0 +/- 2.01 days (p= 0.514) in groups 1 and 2 respectively. Discussion: Intercostal access is as safe as the subcostal access when the access is performed between 11 and 12th intercostal spaces according to lung complications. In this way, we determined that stone-free rates, blood losses, hospitalization and scopy durations were similar in both groups.