Mustafa, Kadihasanoglu, Erkan, Erkan, Ugur, Yucetas, Mehmet, Gokhan Culha, Mahmut, Gokhan Toktas, and Ozcan, Atahan
Micropercutaneous nephrolithotomy (microperc) is a new minimal-invasive technique.We aimed to investigate whether preoperative hydronephrosis has an impact on the stone-free rate of microperc.In this study, 66 consecutive patients were included and divided into 2 groups:patients without preoperative hydronephrosis (group-1) and patients with preoperative hydronephrosis (group-2).Both groups were compared for age, gender, body mass index (BMI), stone burden, stone location, fluoroscopy and operative time, blood loss, stone-free rate and perioperative and postoperative complication rates. Parameters were analyzed using univariate and multivariate analyses for the stone-free rate.The mean age, gender, BMI, stone location, and blood loss were similar in both groups (p0.05). Stone burden in group-2 was greater than group-1 (p=0.011). In addition, mean fluoroscopy time in group-1 was found to be significantly lower (p0.05). However, operative time was comparable among the groups (p=0.169). Lastly, group-2 had a higher rate of perioperative and postoperative complication rates and lower success rate (p=0.023, p=0.027 and p=0.001, respectively). The success was significantly affected by hydronephrosis, stone burden and location (p0.05). Logistic regression analysis revealed that unsuccessful outcome was significantly associated only with the presence of hydronephrosis (OR 0.225,p=0.033).This study seems to suggest that presence of hydronephrosis is a major factor on the stone free rate of microperc procedures.La nefrolitotomíamicropercutanea (microperc) es una nueva técnica mínimamente invasiva. Investigamos si la hidronefrosis preoperatoria tiene un impacto sobre la tasa de pacientes libres delitiasis de la microperc.MÉTODOS: En este estudio, 66 pacientes consecutivos fueron incluidos y divididos en 2 grupos: pacientes sin hidronefrosis preoperatoria (grupo 1) y pacientes con hidronefrosis preoperatoria (grupo 2). Se compararon ambos grupos por edad, género, índice de masa corporal (IMC), carga litiásica, localización de la litiasis, fluoroscopia y tiempo operatorio, sangrado, tasa de pacientes libres de litiasis, y tasas de complicaciones peri y postoperatorias. Las variables fueron analizadas utilizando análisis uni y multivariado para la tasa de pacientes libres de litiasis.Edad media, género, localización de la litiasis y sangrado fueron similares en ambos grupos (p0,05). La carga litiásica en el grupo 2 era mayor que en grupo 1 (p=0,011). Además, el tiempo medio de fluoroscopia en el grupo 1 era significativamente menor (pera comparable en los dos grupos (p=0,169). Finalmente, el grupo 2 tenía una tasa de complicaciones peri y postoperatorias mayor y una tasa de éxitos menor (p=0,023, éxito estaba significativamente influido por la hidronefrosis, la carga litiásica y la localización de la litiasis (p0,05). El análisis de regresión logística reveló que los resultados sin éxito se asociaban significativamente sólo con la presencia de hidronefrosis (OR 0,225,p=0,033).CONCLUSIÓN: Este estudio parece sugerir que la presencia de hidronefrosis es un factor principal en la tasa de pacientes libres de litiasis de los procedimientos de microperc.