Приказ основних података о дисертацији

Evaluation of percutaneous nephrolithotomy efficasy in the treatment of patients with kidney stone

dc.contributor.advisorDžamić, Zoran
dc.contributor.otherMilenković-Petronić, Dragica
dc.contributor.otherVuksanović, Aleksandar
dc.contributor.otherMarušić, Goran
dc.creatorDurutović, Otaš R.
dc.date.accessioned2016-12-30T16:13:16Z
dc.date.available2016-12-30T16:13:16Z
dc.date.available2020-07-03T08:49:06Z
dc.date.issued2016-07-14
dc.identifier.urihttps://nardus.mpn.gov.rs/handle/123456789/7317
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=4295
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:14079/bdef:Content/download
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:14240/bdef:Izvestaj/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=48483343
dc.description.abstractUvod: Perkutana nefrolitolapaksija (PCNL) predstavlja metodu izbora u lečenju kamena (kalkulusa) u bubregu većeg od 2 cm. Metoda pripada grupi endoskopskih minimalno invazivnih procedura. Uprkos manjoj invazivnosti u odnosu na otvorene hirurške tehnike, metoda ima i svoje specifičnosti, na polju bezbednosti i potencijalnih komplikacija. Pristup kamenu se obavlja širenjem kanala kroz parenhim bubrega, nakon ulaska iglom do željenog dela sabirnog sistema bubrega i kamena. Kao i ostale tehnike fragmentisanja kamena u bubregu i PCNL može da ima uticaj na bubrežnu funkciju. Cilj: Analiza (1) uspešnosti PCNL u lečenju kamena u bubregu u odnosu na veličinu, anatomske odnose i lokalizaciju, (2) učestalosti komplikacija kod bolesnika lečenih ovom metodom, u odnosu na veličinu, anatomske odnose i lokalizaciju, (3) uticaja metode na bubrežnu funkciju i eventualnog stepena oštećenja bubrega i (4) učestalosti recidiva. Materijal i metode: Kohortnom studijom su obuhvaćeni pacijenati Klinike za urologiju KCS koji su u periodu od 2010. do 2014. godine operisani PCNL metodom, od strane jednog hirurga. Selekcija pacijenata obavljena je prema preporukama za tretman kalkuloze bubrega Evropske asocijacije urologa i svi su imali kamen veći od 2 cm. Nakon sprovedenih radiografskih procedura karakteristike kalkulusa, veličina, broj i položaj, kao i anatomska građa sabirnog sistema bubrega i samog bubrega sagledavani su korišćenjem „Guy’s Stone Score“ klasifikacije (GSS) i bolesnici su svrstavani u jednu od četiri ponuđene kategorije. Klasifikacija komplikacija izvršena je prema modifikovanom Clavien-Dindo sistemu. Uspeh procedure je definisan kao izostanak rezidualnih fragmenata > 3 mm. Bubrežna funkcija je praćena određivanjem β2-mikroglobulina i mikroalbuminurije. Tri meseca nakon operacije vršena je procena učestalosti recidiva. Rezultati: Ispitivanu populaciju činilo je 111 bolesnika. Medijana starosti bolesnika je iznosila 48 godina. Medijana veličine kamena iznosila je 51 mm. Najmanji kamen bio promera 21 mm, a najveći 91 mm. Klasifikovani prema GSS klasifikaciji, 16,2% bolesnika je pripadalo grupi GSS 1, 18,9% GSS 2, 26,2% GSS 3 i 38,7% grupi GSS 4...sr
dc.description.abstractINTRODUCTION: Percutaneous nephrolithotomy (PCNL) is considered today as a treatment of choice for kidney stones bigger than 2 cm. PCNL is endoscopic, minimally invasive procedure. Beside its low aggressiveness it is accompanied with few specific, critical steps and possible complications. The crucial step to perform successful and safe procedure is renal access. Precise access to the planed and desired part of the kidney collecting system is followed with careful dilatation of the working tract. As all other techniques of kidney stones disintegration, PCNL can possibly impact renal function. OBJECTIVE: The aim of the present study was to investigate 1) PCNL efficacy and 2) PCNL safety, overall and dependent on stone complexity, respectively, 3) possible mechanism of impact on renal function and 4) the frequency of stone recurrence. MATERIAL AND METHODS: The study cohort evaluated all patients of Clinic of urology in Belgrade who underwent PCNL by a single surgeon, between August 2010 and December 2014. The patients were selected according to the Guideline of the European Association of Urology and all stones were bigger than 2 cm. After the appropriate radiological and laboratory investigation the complexity of the stones, but also of kidney anatomy was determined by Guy’s Stone Score classification. Stones were classified to one of the four offered groups. Complications were evaluated using modified Clavien-Dindo classification. For detection of possible impact of PCNL on renal function the micro albumin and β2-microglobulin levels in urine were evaluated. Three months following PCNL the frequency of recurrence was determined. RESULTS: Study cohort gained 111 patients. The median age of the patients was 48 years, while the median stone diameter was 51 mm. The smallest stone was 21 mm and the biggest 91 mm. According to Guy’s Stone Score (GSS) 16,2% of the patients were classified in GSS 1 group, 18,9% in GSS 2, 26,2% in GSS 3 and 38,7% in GSS 4 groups, respectively. The overall efficacy of the study was 75%, as 83 out of 111 patients were stone free after the procedure...en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.rightsopenAccessen
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourceУниверзитет у Београдуsr
dc.subjectKamen u bubregusr
dc.subjectPercutaneous nephrolithotomyen
dc.subjectPCNLen
dc.subjectkidney stoneen
dc.subjectlithotripsyen
dc.subjectPCNL efficacyen
dc.subjectPCNL safetyen
dc.subjectultrasound guidanceen
dc.subjectpulsed fluoroscopyen
dc.subjectradiation exposureen
dc.subjectperkutana nefrolitolapaksijasr
dc.subjectlitotripsijasr
dc.subjectefikasnostsr
dc.subjectbezbednostsr
dc.subjectultrazvučna kontrola pristupasr
dc.subjectizlaganje zračenjusr
dc.subjectpulsna fluoroskopijasr
dc.titleProcena efekata perkutane nefrolitolapaksije u lečenju bolesnika sa kamenom u bubregusr
dc.title.alternativeEvaluation of percutaneous nephrolithotomy efficasy in the treatment of patients with kidney stoneen
dc.typedoctoralThesisen
dc.rights.licenseBY-NC-ND
dcterms.abstractДжамић, Зоран; Марушић, Горан; Миленковић-Петронић, Драгица; Вуксановић, Aлександар; Дурутовић, Оташ Р.; Процена ефеката перкутане нефролитолапаксије у лечењу болесника са каменом у бубрегу; Процена ефеката перкутане нефролитолапаксије у лечењу болесника са каменом у бубрегу;
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/9352/IzvestajKomisije.pdf
dc.identifier.fulltexthttps://nardus.mpn.gov.rs/bitstream/id/9352/IzvestajKomisije.pdf
dc.identifier.fulltexthttps://nardus.mpn.gov.rs/bitstream/id/9351/Disertacija.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/9351/Disertacija.pdf
dc.identifier.rcubhttps://hdl.handle.net/21.15107/rcub_nardus_7317


Документи за докторску дисертацију

Thumbnail
Thumbnail

Ова дисертација се појављује у следећим колекцијама

Приказ основних података о дисертацији