Demirtaş Abdullah, Caniklioğlu Mehmet, Kula Mustafa, Sofikerim Mustafa, Akınsal Emre Can, Ergül Mehmet Ali, Baydilli Numan, Ekemekçioğlu Oğuz
Department of Urology, Erciyes University Faculty of Medicine, 38039 Kayseri, Turkey.
ISRN Urol. 2013 May 8;2013:827121. doi: 10.1155/2013/827121. Print 2013.
Objective. To determine the effects of percutaneous nephrolithotomy on renal functions by using DMSA scintigraphy while considering access counts. Material and Methods. A total of 37 patients who had undergone percutaneous nephrolithotomy were included. Preoperative DMSA scans were performed a day before the surgery, whereas postoperative scans were randomized by evaluating them before (n = 25) and after (n = 12) the 6th postoperative month. Twenty-six of 37 cases underwent percutaneous nephrolithotomy with a single access site and 11 with multiple access sites. Results. There were no significant changes of total renal functions in the whole study group (P = 0.054). In the single access group, total functions were significantly elevated (P = 0.03) In the multiple access group, while treated site functions were significantly decreased (P = 0.01), total functions did not change significantly (P = 0.42). There was an insignificant decrease in those evaluated before the 6th postoperative month (P = 0.27) and an insignificant increase in the others (P = 0.11). Conclusion. We could not find a superiority of single access over multiple accesses. There is a temporary functional loss in the treated site.
目的。通过使用二巯基丁二酸（DMSA）肾闪烁显像术并考虑穿刺通道数量，确定经皮肾镜取石术对肾功能的影响。材料与方法。共纳入37例行经皮肾镜取石术的患者。术前DMSA扫描在手术前一天进行，术后扫描通过在术后第6个月之前（n = 25）和之后（n = 12）进行评估而随机分组。37例患者中，26例经单一穿刺通道行经皮肾镜取石术，11例经多个穿刺通道。结果。整个研究组的总肾功能无显著变化（P = 0.054）。在单一穿刺通道组中，总肾功能显著升高（P = 0.03）。在多个穿刺通道组中，虽然治疗部位的功能显著降低（P = 0.01），但总肾功能无显著变化（P = 0.42）。术后第6个月之前接受评估的患者肾功能有不显著的下降（P = 0.27），其他患者则有不显著的升高（P = 0.11）。结论。我们未发现单一穿刺通道优于多个穿刺通道。治疗部位存在暂时性的功能丧失。
