The effect of ESWL application on surgical results before percutaneous nephrolithotomy operation

INTRODUCTION: Urinary system stone disease is one of the most common and frequently recurring urological diseases. In this study, we investigated the effect of previous ESWL on bleeding during PNL.
METHODS: The data of 403 patients who underwent PNL in our clinic between 2015 and 2023 were retrospectively analyzed. The patients were divided into 2 groups as the group that had ESWL before and the group that did not. The operative times, scopy times, stone loads, hemoglobin decrease levels, blood transfusion rates, hospital stay, intraoperative and postoperative complications were compared statistically.
RESULTS: 112 patients who underwent ESWL before PCNL were named Group 1, and 277 patients who did not undergo ESWL were named Group 2. There was no statistically significant difference between the operative data in terms of stone size, operation time, stone-free rates, wetting cessation time and hospital stay. While the mean decrease in hemoglobin was 1.44 ± 1.09 g/dl in Group 1, it was 1.53 ± 1.09 g/dl in Group 2, and there was no statistically significant difference between the two groups in terms of bleeding (p=0.085). While the blood transfusion rate was 6% in Group 1, the blood transfusion rate was 7% in Group 2 (p=0.138).
DISCUSSION AND CONCLUSION: PNL operation can be performed effectively and reliably in experienced centers in patients who have undergone ESWL before.

Perkütan nefrolitotomi operasyonu öncesi ESWL uygulanmasýnýn cerrahi sonuçlara etkisi

GÝRÝÞ ve AMAÇ: Üriner sistem taþ hastalýðý sýk görülen ve sýk tekrarlayan ürolojik hastalýklardan biridir. Bu çalýþmamýzda, önceki ESWL'nin PNL sýrasýndaki kanama üzerindeki etkisini araþtýrdýk.

YÖNTEM ve GEREÇLER: Kliniðimizde 2015-2023 yýllarý arasýnda PNL yapýlan 403 hastanýn verileri retrospektif olarak incelendi. Hastalar daha önce ESWL yapýlan grup ve yapýlmayan grup olarak 2’ye ayrýldý. Hastalarýn operasyon süreleri, skopi süreleri, taþ yükleri, hemoglobin düþüþ düzeyleri, kan transfüzyon oranlarý, hastanede kalýþ süreleri, intraopeatif ve postoperatif komplikasyon durumlarý istatistiksel olarak karþýlaþtýrýldý.
BULGULAR: PCNL öncesi ESWL yapýlmýþ 112 hasta Grup 1, ESWL yapýlmamýþ 277 hasta Grup 2 olarak adlandýrýldý. Operatif verilerden taþ boyutu, operasyon süresi, taþsýzlýk oranlarý, ýslatma kesilme süresi, hastanede kalýþ süresi açýsýndan istatistiksel anlamlý fark görülmedi. Grup 1’de ortalama hemoglobin düþüþü 1.44 ± 1.09 g/dl iken Grup 2’de 1.53 ± 1.09 g/dl olarak bulundu ve iki grup arasýnda kanama açýsýndan istatistiksel anlamlý fark görülmedi (p=0.085). Grup 1'de kan transfüzyonu oraný %6 iken Grup 2’de kan transfüzyonu oraný % 7 olarak bulundu (p=0.138).
TARTIÞMA ve SONUÇ: PNL operasyonu daha önce ESWL yapýlan hastalarda deneyimli merkezlerde etkin ve güvenilir þekilde uygulanabilir.