Fakülteler / Faculties
Permanent URI for this communityhttps://hdl.handle.net/11727/1395
Browse
3 results
Search Results
Item Renal Stone Composition Does not Affect The Outcome of Percutaneous Nephrolithotomy in Children(2018) Kaygisiz, Onur; Turegun, Fethi Ahmet; Satar, Nihat; Ozen, Ender; Toksoz, Serdar; Dogan, Hasan Serkan; Piskin, Mehmet Mesut; Izol, Volkan; Sarikaya, Saban; Kilicarslan, Hakan; Cicek, Tufan; Ozturk, Ahmet; Tekgul, Serdar; Onal, Bulent; 29761226Purpose We sought to investigate the association between renal stone composition and percutaneous nephrolithotomy outcomes in pediatric patients and define the characterization of the stone composition. Methods The data of 1157 children who underwent percutaneous nephrolithotomy between 1991 and 2012 were retrieved from the multicenter database of the Turkish Pediatric Urology Society. The study population comprised 359 children (160 girls, 199 boys) with stone analyses. Patients were divided into five groups according to the stone composition [group 1: calcium oxalate; group 2: calcium phosphate; group 3: infection stones (magnesium ammonium phosphate, ammonium urate); group 4: cystine; group 5: uric acid, xanthine stones]. Results Patient characteristics, perioperative, postoperative, and stone characteristics were compared considering the stone composition. There were no significant differences between the groups concerning age, sex, side involved, preoperative hematocrit levels, and solitary renal unit. Patients with cystine stones were more likely to have a history of stone treatment. Groups 2 and 5 had mostly solitary stones. However, group 3 had staghorn stone more often, and group 4 frequently had multiple stones. Overall stone-free rate (79.4%) was similar among the groups. Although stone composition was related to blood transfusion and prolonged operative and fluoroscopy screening times on univariate analysis, it was not a significant predictor of them on multivariate analysis. Conclusions Stone composition was not a predictor of outcomes of pediatric percutaneous nephrolithotomy. However, cystine and infection stones, which are larger and filled multiple calyxes due to the nature of stone forming, were more challenging cases that need multiple tracts.Item Factors Predicting Postoperative Febrile Urinary Tract Infection Following Percutaneous Nephrolithotomy in Prepubertal Children(2018) Kaygisiz, Onur; Satar, Nihat; Gunes, Ali; Dogan, Hasan Serkan; Erozenci, Ahmet; Ozden, Ender; Piskin, Mehmet Mesut; Demirci, Deniz; Toksoz, Serdar; Cicek, Tufan; Gurocak, Serhat; Kilicarslan, Hakan; Nazli, Oktay; Kefi, Aykut; Izol, Volkan; Beytur, Ali; Sarikaya, Saban; Tekgul, Serdar; Onal, Bulent; 29779995Predictive tables and scoring systems can predict stone clearance. However, there is a paucity of evidence regarding the prediction of complications during percutaneous nephrolithotomy (PCNL), particularly in children, which remains under-researched. To our knowledge, no studies have evaluated the risk factors for febrile urinary tract infection (FUTI) after pediatric PCNL. Objectives To assess the predictive factors of FUTI in prepubertal children after PCNL and determine whether any prophylactic cephalosporins are superior for decreasing the FUTI rate. Study design Data from 1157 children who underwent PCNL between 1991 and 2012 were retrieved from the multicenter database of the Turkish Pediatric Urology Society. Children >12 years of age were excluded, leaving 830 children (364 girls, 466 boys). Data were analyzed according to the presence of FUTI and compared between the FUTI and non-FUTI groups. Results Mean age was 6.46 +/- 3.38 years. Twenty-nine (3.5%) children had FUTI which was confirmed by urine culture. FUTI Table Predictive factors for FUTI. occurred more frequently in young children (5.5%) than school-age children (2.4%). In univariate analysis, there were significant differences between the FUTI and non-FUTI groups regarding age, cephalosporin subgroup (first, second and third generation cephalosporin), side of PCNL, staghorn stones, tract size, operative time, postoperative ureteral catheter usage, perioperative complications (SATAVA), and blood transfusion. Multivariate analysis revealed that age, side of PCNL, staghorn stones, tract size, operative time, and blood transfusion were independent predictors of FUTI. Discussion The smaller tract size could cause FUTI with poor fluid drainage that may lead to elevate renal pelvic pressure and trigger bacteremia-causing pyelovenous backflow. Filling the calyx and renal pelvis by a staghorn stone and the resulting obstruction of fluid drainage may elevate intrarenal pelvis pressure. Longer operative time is likely to increase renal pelvic pressure over longer periods, which may account for FUTI after pediatric PCNL. Conclusions Younger age, right-sided PCNL, staghorn stones, mini-PCNL, longer operative time, and blood transfusion are risk factors for FUTI. First-, second-, and third-generation cephalosporins are equally effective for prophylaxis in prepubertal children undergoing PCNL.Item Ability of ESWL nomograms to predict stone-free rate in children(2021) Ceyhan, Erman; Ozer, Cevahir; Ozturk, Bulent; Tekin, Mehmet Ilteris; Aygun, Yuksel Cem; 0000-0001-8223-6399; 0000-0002-6232-4313; 0000-0002-7850-6912; 33867289; ABI-2513-2020; AAM-3015-2021; AAM-2222-2020Introduction We aimed to evaluate whether the pediatric extracorporeal shock wave lithotripsy (ESWL) nomograms can predict stone-free status in children effectively and whether they are applicable to our series. We hypothesize that two current nomograms predicting successful treatment with ESWL in pediatric patients are valid. Study design We evaluated 415 renal units (children <18 years) with eligible data who received ESWL treatment for upper urinary tract stones. Children's age, gender, stone size, stone surface area, stone location and history of previous intervention were recorded. Children with no residual fragments after ESWL treatment were designated as stone-free. The nomograms described by Dogan and Onal were implemented to our series for the prediction of stone-free status. Results Mean age of children was 64.7 +/- 57.2 months. Male to female ratio was 219:196.78.8% (327) of children had single stone. Mean stone size was 10.0 +/- 3.7 mm and mean stone surface area was 380.0 +/- 72.2 mm(2). Our stone-free rate after single ESWL session was 52.5% (218/415). Mean residual stone size and stone surface area after single session was 6.4 +/- 3.3 mm and 36.0 +/- 44.2 mm(2) respectively. There were no significant difference between stone-free children and children with residual fragments regarding gender, age and history of previous intervention. Mean stone size and stone surface area in stone-free children were lower and lower pole stones had the lowest stone-free rate (p < 0.05). Area under curve for Dogan and Onal nomogram were 0.628 and 0.580 respectively in ROC analysis (0.05). The agreement between Dogan and Onal score was moderate in our series. In multivariate analysis only stone surface area and Dogan score found to be independent predictors of stone-free status (p < 0.05). Discussion Only one study has assessed both nomograms in the literature. Both nomograms are reported to be independent predictors of stone free status. ROC analysis in our study revealed fair accuracy for both nomograms with higher area under curve for Dogan nomogram. Higher accuracy for both nomograms were reported by other authors. These nomograms offer practical data but more effective tools are needed to be developed for the prediction of stone-free status in pediatric ESWL. Conclusions Stone size and stone surface area are associated with stone clearance. Dogan and Onal nomograms can be useful in prediction of stone-free status in children. Dogan nomogram is superior to Onal nomogram. [GRAPHICS]