Department of Urology, Muljibhai Patel Urological Hospital , Nadiad, India.
J Endourol. 2011 Aug;25(8):1263-8. doi: 10.1089/end.2011.0055. Epub 2011 Jul 20.
The study compared characteristics and outcomes in patients with staghorn or nonstaghorn stones who were treated with percutaneous nephrolithotomy (PCNL) within the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study.
Data over a 1-year period from consecutively treated patients from 96 centers worldwide were collated. The following variables in patients with staghorn or nonstaghorn stones were compared: National prevalence, patient characteristics, access method, puncture frequency and outcomes, including bleeding rates, operative time, and duration of hospital stay.
Data from 5335 eligible patients were collated; 1466 (27.5%) with staghorn and 3869 (72.5%) with nonstaghorn stones. Staghorn stone presentation varied between centers from 67% in Thailand to 13% in Argentina. The frequencies of previous procedures were similar between groups, but shockwave lithotripsy was less frequent in patients with staghorn stones compared with nonstaghorn (16.8% vs 22.6%) and positive preoperative urine cultures were more frequent in patients with staghorn than nonstaghorn stones (23.4% vs 13.1%). Patients with staghorn stones underwent multiple punctures more frequently than those with nonstaghorn stones (16.9% vs 5.0%). Postoperative fever, bleeding, and the need for blood transfusion were more frequent, the median operative time and duration of hospital stay were longer, while the proportion of patients remaining stone free was lower (56.9% vs 82.5%) in patients with staghorn than nonstaghorn stones.
The proportion of patients with staghorn stones varies widely between centers. Stone-free rates were lower, complications more frequent, and operative time and hospital stay were longer in patients with staghorn stones.
本研究比较了接受经皮肾镜碎石取石术（PCNL）治疗的鹿角形和非鹿角形结石患者的特征和结局，这些患者数据来自于欧洲泌尿外科学会（EAU）经皮肾镜碎石取石术全球研究（CROES PCNL 全球研究）的 96 个中心。
对来自全球 96 个中心的连续治疗患者在 1 年时间内的数据进行了整理。对鹿角形和非鹿角形结石患者的以下变量进行了比较：国家患病率、患者特征、入路方式、穿刺次数和结局，包括出血率、手术时间和住院时间。
共整理了 5335 名符合条件的患者数据；其中 1466 名（27.5%）为鹿角形结石，3869 名（72.5%）为非鹿角形结石。中心之间鹿角形结石的表现从泰国的 67%到阿根廷的 13%不等。两组患者的既往手术频率相似，但鹿角形结石患者接受冲击波碎石术的频率低于非鹿角形结石患者（16.8%比 22.6%），而术前尿液培养阳性的患者在鹿角形结石患者中更为常见，而非鹿角形结石患者（23.4%比 13.1%）。鹿角形结石患者的穿刺次数比非鹿角形结石患者更为频繁（16.9%比 5.0%）。术后发热、出血和输血需求更为常见，中位手术时间和住院时间更长，而鹿角形结石患者的结石清除率低于非鹿角形结石患者（56.9%比 82.5%）。
中心之间鹿角形结石患者的比例差异很大。鹿角形结石患者的结石清除率较低，并发症更常见，手术时间和住院时间更长。
