Outcomes of robot-assisted transperitoneal pyeloplasty: Case series

Amac: Uretero pelvik bileske (UPB) darliklari idrarin renal pelvisten uretere gecisini kisitlayan ve gerekli durumlarda tedavi edilmezse kademeli olarak bobrek fonksiyonlarinda kayiba yol acabilen bir durum olarak kabul edilir. UPB darliklarini distan basi yada ic tikanikliga bagli olabilir. Semptomatik UPB darliklari tedavi edilmelidir. Biz bu calismamizda klinigimizde robot yardimli piyeloplasti (RYP) yaptigimiz hastalarin sonuclarini sunmayi amacladik. Yontemler: Klinigimizde Ocak 2017 - 2019 tarihleri arasinda RYP yaptigimiz 15 hastanin verileri incelendi. Uretero pelvik bileske darligi (UPBD) tanisi, intravenoz piyelografi (IVP) ve diurez renografisi (DTPA) ile hasta muayenesi veya olasi kontrolleri takiben yapildi. Da Vinci XI 4 kollu robotik sistem kullanan tum hastalara dismembred piyeloplasti yapildi. Sonuclar retrospektif olarak degerlendirildi. Bulgular: Hastalarin yas ortalamasi 41,3 (8,2) idi. Cinsiyet dagilimi 7 erkek, 8 kadindi. Tum islemler birincil olgularda yapildi. Hastalarin 6' sinda intrinsik obstruksiyon, 9' unda distan dammar basisina bagli ekstrinsik obstruksiyon vardi. Ortalama ameliyat suresi 155,3 (29,8) dakika idi. Ortalama anastomoz suresi 33,4 (8,1) dakika idi. Intraoperatif kanama miktari 48 (10.2) cc olarak bulundu. Ortalama hastanede kalis suresi 3,6 (1,1) gundu. Hicbir hastada acik cerrahi mudahale olmadi. Hicbir hastada intraoperatif veya postoperatif komplikasyon gozlenmedi. Ortalama takip suresi 12,7 (5,4) aydi. Postoperatif IVP ve DTPA tum hastalarin duzeldigi tespit edildi. Sonuc: Calismamizda tespit edildigi gibi, RYP UPBD tedavisinde basarili cerrahi ve fonksiyonel sonuclari olan minimal bir invaziv yontemdir.

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