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Amaç: Bu çalışmamızdaki amaç, okul öncesi (0-7 yaş) ve okul çağı (8-16) dönemindeki böbrek taşı tedavisinde şok dalga litotripsi (SWL) etkinliğinin ve güvenilirliğinin retrospektif olarak karşılaştırılmasıdır. Gereç ve Yöntemler: Ocak 2014 - Ocak 2018 tarihleri arasında böbrek taşı olan ve SWL ile tedavi edilen 16 yaşından küçük toplam 283 çocuk hastanın verileri retrospektif olarak incelendi. Hastalar okul öncesi (Grup 1, <7 yaş) ve okul çağı (Grup 2, 7-16 yaş) olmak üzere iki gruba ayrıldı. Tanı, direkt üriner sistem grafisi, ultrasonografi, intravenöz ürografi ve/veya azaltılmış doz kontrastsız bilgisayarlı tomografi ile konuldu. Gruplar başarı, odaklama yöntemi, taş lokalizasyonu, boyut, opasite ve komplikasyonlar açısından değerlendirildi. Bulgular: İki yüz seksen üç çocuk hastanın 166 (%58.6)’sı erkek 117 (%41.4)’si ise kız idi. SWL başarı oranları grup 1’de 127/132 (%96.2) ve grup 2’ de 136/151 (%90.1) olarak belirlendi. Grup 1’de 108 (%81.8) ve grup 2’de 93 (%61.6) hastada taş boyutlarının ≤ 10 mm olduğu belirlendi. Sırasıyla 1. ve 2. gruplarda opak / non-opak taş oranı 54 (%40.9) / 78 (%59.1) ve 104 (%68.9) / 47 (%31.1) idi. Grup 1’de 5 (%3.8), grup 2’de ise 6 (%4) hastada komplikasyon izlendi. Sonuç: Çocukluk çağında görülen taş hastalığında tedavi için birçok alternatif tedavi yöntemi olmasına rağmen, SWL hala güncelliğini korumakta ve uygun olgularda hala ilk basamak tedavi seçeneği olarak kullanılmaktadır. Okul çağı dönemine göre okul öncesi dönemde, kırılan taş fragmanlarının pasajı ve temizlenmesi daha kolaydır ve SWL başarısını arttırmaktadır. Okul öncesi çocuklardaki üriner sistem taş hastalığının tedavisinde SWL, okul çağındaki çocuklardan daha başarılıdır. Randomize prospektif daha büyük hasta serileri ile bu durum daha iyi aydınlatılabilecektir.
Purpose: The aim of this study is to retrospectively compare the effectiveness and reliability of shock wave litotripsy (SWL) in pre-school (0-7 years) and school age (8-16 years) in kidney stone treatment. Tools and Methods: In total, 283 children under the age of 16 who had a kidney stone and were treated with SWL between January 2014 and January 2018 were examined retrospectively. Patients were divided into two groups: pre-school (Group 1, <7 years old) and school age (Group 2, 7-16 years old). The diagnosis was made with direct urine system graphics, ultrasound, intravenous urography and/or reduced doses with uncontrasted computer tomography. The groups were evaluated in terms of success, focus method, stone localization, size, obsession and complications. Results: Two hundred and seventy-three children of the patients were 166 (58.6%) men 117 (41.4%) and girls. The SWL success rates were 127/132 in Group 1 (96.2) and 136/151 in Group 2 (90.1). 108 patients in group 1 (81.8) and 93 patients in group 2 (61.6) were found to have stone sizes ≤ 10 mm. Accordingly, in the 1st and 2nd groups, the impact / non-impact stone ratio was 54 (%40.9) / 78 (%59.1) and 104 (%68.9) / 47 (%31.1). 5 patients in group 1 (3.8%) and 6 patients in group 2 (4%) were diagnosed with complications. The result: Although there are many alternative treatments for the treatment of the stone disease seen in childhood, SWL remains up to date and is still used as the first step treatment option in appropriate circumstances. According to school age, in the pre-school period, the passage and cleaning of broken stone fragments is easier and increases the success of SWL. In the treatment of urine system stone disease in pre-school children, SWL is more successful than children in school age. With the randomized prospective larger series of patients, this situation will be able to be better illuminated.
Objective: The aim of this study was to retrospectively compare the efficacy and safety of shock wave lithotripsy (SWL) in preschool (0-7 years) and school age (8-16) period. Material and Methods: The data of 283 pediatric patients under the age of 16 years who were treated with SWL between January 2014 and January 2018 were analyzed retrospectively. The patients were divided into two groups as preschool (Group 1, <7 years) and school age (Group 2, 7-16 years). The diagnosis was made by direct urinary tract X-ray, ultrasonography, intravenous urography and/or reduced-dose non-contrast computed tomography. The groups were evaluated in terms of success, focusing method, stone localization, size, opacity and complications. Results: Of the 283 pediatric patients, 166 (58.6%) were male and 117 (41.4%) were female. SWL success rates were 127/132 (96.2%) in group 1 and 136/151 (90.1%) in group 2. In 108 patients (81.8%) and 93 (61.6%) patients in group 2, stone sizes were less than 10 mm. The ratio of opaque / non-opaque stones in groups 1 and 2 was respectively 54 (40.9%) / 78 (59.1%) and 104 (68.9%) / 47 (31.1%). Complications were observed in 5 patients (3.8%) of group 1 and 6 (4%) patients in group 2. Conclusion: Although there are many alternative methods of treatment for stone disease in childhood, SWL is still used as a first-line treatment option in appropriate cases currently. In the preschool period, the passage and clearance of the broken stone fragments is easier than in the school age period and increases the success of SWL. In the treatment of urinary tract stone disease in preschool children, SWL is more successful than school-age children. This will be better elucidated by larger randomized prospective patient series.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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