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İdrar Taşı Olan Yaşlı Hastalarda Şok Dalgası Litotripsi Sonrası Taşsızlık Oranını Etkileyen Faktörlerin Araştırılması

Yıl 2021, Cilt: 23 Sayı: 3, 289 - 293, 30.12.2021

Alpaslan Yüksel Dursun Baba Yusuf Şenoğlu Arda Taşkın Taşkıran

https://doi.org/10.18678/dtfd.1005283

Öz

Amaç: Üriner taş hastalığı, yaşlı hastalar da dahil olmak üzere tüm yaş gruplarında görülen önemli bir hastalıktır. Böbrek yetmezliği ve idrar yolu enfeksiyonu sorunlarına neden olabilir. Farklı tedavi alternatifleri arasında minimal invaziv olan şok dalga tedavisi böbrek ve proksimal üreter taşlarında 2 cm'den küçük olanlarda tercih edilmektedir. Yaşlı hastalarda bu tedavinin etkinliği ve güvenliği ile ilgili çalışmalar sınırlıdır. Bu çalışmada, üriner taşları olan yaşlı hastalarda şok dalga litotripsi sonrası taşsızlık oranını (stone-free rate, SFR) etkileyen faktörlerin araştırılması amaçlanmıştır.
Gereç ve Yöntemler: 2010 ve 2018 yılları arasında Düzce Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı'nda üriner sistem taş hastalığı nedeniyle ekstrakorporeal şok dalga litotripsi (extracorporeal shock wave lithotripsy, ESWL) uygulanan 65 yaş üstü 120 hastanın verileri retrospektif olarak değerlendirildi. Bu hastalardan elde edilen cinsiyet, yaş, taşın bulunduğu yer (üst, orta veya alt kaliks, renal pelvis, üreter), şok dalgalarının sayısı, taş boyutu ve yardımcı prosedüre duyulan ihtiyacı içeren veriler analiz edildi.
Bulgular: 120 hastanın 82'si (%68,3) erkek, 38'i (%31,7) kadındı. 49 hastada komorbidite mevcuttu. Toplam SFR %65,8 (n=79) olarak bulundu. En yüksek SFR %79,3 (29 hastanın 23'ü) ile orta kaliks taşlarında bulundu. 36 (%30) hastada ESWL sonrası yardımcı prosedürlere ihtiyaç duyuldu. İki hastada subkapsüler renal hematom ve piyelonefrit gelişti.
Sonuç: ESWL, uygun taş boyutuna sahip yaşlı erkekler için bile ilk seçenektir. Ayrıca, ESWL yaşlı hastalarda kabul edilebilir morbiditeye neden olmuştur.

Anahtar Kelimeler

komorbidite yaşlı ekstrakorporal şok dalga tedavisi urolitiyazis

Kaynakça

  • Lamacchia GB, Korkes F, Baccaglini W, de Mello LGM, Szwarc M, Tobias-Machado M. A large series of extracorporeal shock-wave lithotripsy in the very elderly. Ther Adv Urol. 2019;11:1756287219870412.
  • Pearle MS, Calhoun EA, Curhan GC; Urologic Diseases of America Project. Urologic diseases in America project: urolithiasis. J Urol. 2005;173(3):848-57.
  • Yasui T, Iguchi M, Suzuki S, Kohri K. Prevalence and epidemiological characteristics of urolithiasis in Japan: national trends between 1965 and 2005. Urology. 2008;71(2):209-13.
  • Feng L, Yap KB, Yeoh LY, Ng TP. Kidney function and cognitive and functional decline in elderly adults: findings from the Singapore longitudinal aging study. J Am Geriatr Soc. 2012;60(7):1208-14.
  • Bartoletti R, Cai T, Mondaini N, Melone F, Travaglini F, Carini M, et al. Epidemiology and risk factors in urolithiasis. Urol Int. 2007;79(Suppl 1):3-7.
  • Knoll T, Schubert AB, Fahlenkamp D, Leusmann DB, Wendt-Nordahl G, Schubert G. Urolithiasis through the ages: data on more than 200,000 urinary stone analyses. J Urol. 2011;185(4):1304-11.
  • Yoshida O, Terai A, Ohkawa T, Okada Y. National trend of the incidence of urolithiasis in Japan from 1965 to 1995. Kidney Int. 1999;56(5):1899-904.
  • Kates M, Matlaga BR. Stones in the elderly. Curr Geri Rep. 2014;3:14-8.
  • Hollingsworth JM, Rogers MA, Kaufman SR, Bradford TJ, Saint S, Wei JT, et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet. 2006;368(9542):1171-9.
  • Tzelves L, Türk C, Skolarikos A. European Association of Urology Urolithiasis Guidelines: Where are we going? Eur Urol Focus. 2021;7(1):34-8.
  • Zheng C, Yang H, Luo J, Xiong B, Wang H, Jiang Q. Extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery for treatment for renal stones 1-2 cm: a meta-analysis. Urolithiasis. 2015;43(6):549-56.
  • Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP, et al. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART I. J Urol. 2016;196(4):1153-60.
  • Polat F, Yeşil S, Ak E, Farahvash A, Karaoğlan U, Biri H, et al. Safety of ESWL in elderly: evaluation of independent predictors and comorbidity on stone-free rate and complications. Geriatr Gerontol Int. 2012;12(3):413-7.
  • Ng CF, Wong A, Tolley D. Is extracorporeal shock wave lithotripsy the preferred treatment option for elderly patients with urinary stones? A multivariate analysis of the effect of patient age on treatment outcome. BJU Int. 2007;100(2):392-5.
  • Ackermann DK, Fuhrimann R, Pfluger D, Studer UE, Zingg EJ. Prognosis after extracorporeal shock wave lithotripsy of radioopaque renal calculi: a multivariate analysis. Eur Urol. 1994;25(2):105-9.
  • Philippou P, Lamrani D, Moraitis K, Bach C, Masood J, Buchholz N. Is shock wave lithotripsy efficient for the elderly stone formers? Results of a matched-pair analysis. Urol Res. 2012;40(4):299-304.
  • Sighinolfi MC, Micali S, Grande M, Mofferdin A, De Stefani S, Bianchi G. Extracorporeal shock wave lithotripsy in an elderly population: how to prevent complications and make the treatment safe and effective. J Endourol. 2008;22(10):2223-6.
  • Abdel-Khalek M, Sheir K, Elsobky E, Showkey S, Kenawy M. Prognostic factors for extracorporeal shock-wave lithotripsy of ureteric stones--a multivariate analysis study. Scand J Urol Nephrol. 2003;37(5):413-8.

Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients with Urinary Stones After Shock Wave Lithotripsy

Yıl 2021, Cilt: 23 Sayı: 3, 289 - 293, 30.12.2021

Alpaslan Yüksel Dursun Baba Yusuf Şenoğlu Arda Taşkın Taşkıran

https://doi.org/10.18678/dtfd.1005283

Öz

Aim: Urinary stone disease is an important disease seen in all age groups, including elderly patients. It can cause kidney failure and urinary infection problems. Shock wave therapy, which is the minimal invasive among the different treatment alternatives, is preferred for kidney and proximal ureteral stones smaller than 2 cm. Studies on the efficacy and safety of this treatment in elderly patients are limited. This study aimed to investigate the factors affecting the stone-free rate (SFR) in elderly patients with urinary stones after shock wave lithotripsy.
Material and Methods: The data of 120 patients in the Urology department of Duzce University Faculty of Medicine between 2010 and 2018 over 65 years old who underwent extracorporeal shock wave lithotripsy (ESWL) for urinary system stone disease were evaluated retrospectively. The data obtained from these patients included sex, age, location of the stone (upper, middle, or lower calyx, renal pelvis, ureter), number of shock waves, stone size, and the need for the auxiliary procedure were analyzed.
Results: Of the 120 patients, 82 (68.3%) were male and 38 (31.7%) were female. Comorbidity was present in 49 patients. An overall SFR of 65.8% (n=79) was found. The highest SFR was found in middle calyx stones with 79.3% (23 of the 29 patients). Post-ESWL auxiliary procedures were needed in 36 (30%) patients. Two patients developed subcapsular renal hematoma and pyelonephritis.
Conclusion: ESWL is an appropriate even the first option for elder male with favorable stone size. Furthermore, ESWL caused acceptable morbidity in older patients.

Anahtar Kelimeler

comorbidities elderly extracorporeal shock wave lithotripsy urolithiasis

Kaynakça

  • Lamacchia GB, Korkes F, Baccaglini W, de Mello LGM, Szwarc M, Tobias-Machado M. A large series of extracorporeal shock-wave lithotripsy in the very elderly. Ther Adv Urol. 2019;11:1756287219870412.
  • Pearle MS, Calhoun EA, Curhan GC; Urologic Diseases of America Project. Urologic diseases in America project: urolithiasis. J Urol. 2005;173(3):848-57.
  • Yasui T, Iguchi M, Suzuki S, Kohri K. Prevalence and epidemiological characteristics of urolithiasis in Japan: national trends between 1965 and 2005. Urology. 2008;71(2):209-13.
  • Feng L, Yap KB, Yeoh LY, Ng TP. Kidney function and cognitive and functional decline in elderly adults: findings from the Singapore longitudinal aging study. J Am Geriatr Soc. 2012;60(7):1208-14.
  • Bartoletti R, Cai T, Mondaini N, Melone F, Travaglini F, Carini M, et al. Epidemiology and risk factors in urolithiasis. Urol Int. 2007;79(Suppl 1):3-7.
  • Knoll T, Schubert AB, Fahlenkamp D, Leusmann DB, Wendt-Nordahl G, Schubert G. Urolithiasis through the ages: data on more than 200,000 urinary stone analyses. J Urol. 2011;185(4):1304-11.
  • Yoshida O, Terai A, Ohkawa T, Okada Y. National trend of the incidence of urolithiasis in Japan from 1965 to 1995. Kidney Int. 1999;56(5):1899-904.
  • Kates M, Matlaga BR. Stones in the elderly. Curr Geri Rep. 2014;3:14-8.
  • Hollingsworth JM, Rogers MA, Kaufman SR, Bradford TJ, Saint S, Wei JT, et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet. 2006;368(9542):1171-9.
  • Tzelves L, Türk C, Skolarikos A. European Association of Urology Urolithiasis Guidelines: Where are we going? Eur Urol Focus. 2021;7(1):34-8.
  • Zheng C, Yang H, Luo J, Xiong B, Wang H, Jiang Q. Extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery for treatment for renal stones 1-2 cm: a meta-analysis. Urolithiasis. 2015;43(6):549-56.
  • Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP, et al. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART I. J Urol. 2016;196(4):1153-60.
  • Polat F, Yeşil S, Ak E, Farahvash A, Karaoğlan U, Biri H, et al. Safety of ESWL in elderly: evaluation of independent predictors and comorbidity on stone-free rate and complications. Geriatr Gerontol Int. 2012;12(3):413-7.
  • Ng CF, Wong A, Tolley D. Is extracorporeal shock wave lithotripsy the preferred treatment option for elderly patients with urinary stones? A multivariate analysis of the effect of patient age on treatment outcome. BJU Int. 2007;100(2):392-5.
  • Ackermann DK, Fuhrimann R, Pfluger D, Studer UE, Zingg EJ. Prognosis after extracorporeal shock wave lithotripsy of radioopaque renal calculi: a multivariate analysis. Eur Urol. 1994;25(2):105-9.
  • Philippou P, Lamrani D, Moraitis K, Bach C, Masood J, Buchholz N. Is shock wave lithotripsy efficient for the elderly stone formers? Results of a matched-pair analysis. Urol Res. 2012;40(4):299-304.
  • Sighinolfi MC, Micali S, Grande M, Mofferdin A, De Stefani S, Bianchi G. Extracorporeal shock wave lithotripsy in an elderly population: how to prevent complications and make the treatment safe and effective. J Endourol. 2008;22(10):2223-6.
  • Abdel-Khalek M, Sheir K, Elsobky E, Showkey S, Kenawy M. Prognostic factors for extracorporeal shock-wave lithotripsy of ureteric stones--a multivariate analysis study. Scand J Urol Nephrol. 2003;37(5):413-8.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Alpaslan Yüksel 0000-0003-0076-4812

Dursun Baba 0000-0002-4779-6777

Yusuf Şenoğlu 0000-0002-3072-9252

Arda Taşkın Taşkıran Bu kişi benim 0000-0003-4556-3475

Yayımlanma Tarihi 30 Aralık 2021
Gönderilme Tarihi 6 Ekim 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 23 Sayı: 3

Kaynak Göster

APA Yüksel, A., Baba, D., Şenoğlu, Y., Taşkıran, A. T. (2021). Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients with Urinary Stones After Shock Wave Lithotripsy. Duzce Medical Journal, 23(3), 289-293. https://doi.org/10.18678/dtfd.1005283
AMA Yüksel A, Baba D, Şenoğlu Y, Taşkıran AT. Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients with Urinary Stones After Shock Wave Lithotripsy. Duzce Med J. Aralık 2021;23(3):289-293. doi:10.18678/dtfd.1005283
Chicago Yüksel, Alpaslan, Dursun Baba, Yusuf Şenoğlu, ve Arda Taşkın Taşkıran. “Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients With Urinary Stones After Shock Wave Lithotripsy”. Duzce Medical Journal 23, sy. 3 (Aralık 2021): 289-93. https://doi.org/10.18678/dtfd.1005283.
EndNote Yüksel A, Baba D, Şenoğlu Y, Taşkıran AT (01 Aralık 2021) Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients with Urinary Stones After Shock Wave Lithotripsy. Duzce Medical Journal 23 3 289–293.
IEEE A. Yüksel, D. Baba, Y. Şenoğlu, ve A. T. Taşkıran, “Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients with Urinary Stones After Shock Wave Lithotripsy”, Duzce Med J, c. 23, sy. 3, ss. 289–293, 2021, doi: 10.18678/dtfd.1005283.
ISNAD Yüksel, Alpaslan vd. “Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients With Urinary Stones After Shock Wave Lithotripsy”. Duzce Medical Journal 23/3 (Aralık 2021), 289-293. https://doi.org/10.18678/dtfd.1005283.
JAMA Yüksel A, Baba D, Şenoğlu Y, Taşkıran AT. Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients with Urinary Stones After Shock Wave Lithotripsy. Duzce Med J. 2021;23:289–293.
MLA Yüksel, Alpaslan vd. “Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients With Urinary Stones After Shock Wave Lithotripsy”. Duzce Medical Journal, c. 23, sy. 3, 2021, ss. 289-93, doi:10.18678/dtfd.1005283.
Vancouver Yüksel A, Baba D, Şenoğlu Y, Taşkıran AT. Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients with Urinary Stones After Shock Wave Lithotripsy. Duzce Med J. 2021;23(3):289-93.
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