Deters L A, Jumper C M, Steinberg P L, Pais V M
Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
Clin Nephrol. 2011 Nov;76(5):354-7. doi: 10.5414/cn106787.
There is no standardized definition of stone free after renal stone surgery. The lack of standardization prompted a review of the current urologic literature, to assess the definitions of stone free status, and how imaging is used to determine stone free status.
A literature search on PubMed for the MeSH terms for percutaneous nephrolithotomy (PCNL), ureteroscopy with lithotripsy, shock wave lithotripsy (SWL), and laser lithotripsy, published in English between January 2007 and January 2010 was performed. Case reports, articles not evaluating stone free outcomes, and review articles were excluded. Articles were evaluated for the treatment modality, definition of stone free status, and the imaging modality employed to determine stone free status.
This search yielded 417 articles of which 249 met inclusion criteria. Stone free was defined in 169 articles (68%). The most common definition of stone free was "no stones" (47%), but a total of seven different definitions were encountered. The most common treatment modality was PCNL (47%), followed by SWL (33%), and URS (13%). The most common detection modality was KUB alone (28%), the second most common being KUB and US combined (22%).
Nearly one-third of articles evaluating surgical management of urinary calculi do not define stone free status; when stone free is defined, there is wide variation as to that definition. Furthermore, vast differences exist in the type of imaging used to define stone free status. The urologic community should standardize the reporting of stone free outcomes in the urologic literature.
肾结石手术后无结石状态尚无标准化定义。缺乏标准化促使对当前泌尿外科文献进行综述，以评估无结石状态的定义以及如何利用影像学来确定无结石状态。
在PubMed上检索2007年1月至2010年1月期间以英文发表的关于经皮肾镜取石术（PCNL）、输尿管镜碎石术、冲击波碎石术（SWL）和激光碎石术的医学主题词。排除病例报告、未评估无结石结局的文章以及综述文章。对文章的治疗方式、无结石状态的定义以及用于确定无结石状态的影像学方式进行评估。
该检索产生417篇文章，其中249篇符合纳入标准。169篇文章（68%）对无结石进行了定义。最常见的无结石定义是“无结石”（47%），但总共遇到了七种不同的定义。最常见的治疗方式是PCNL（47%），其次是SWL（33%）和URS（13%）。最常见的检测方式是单独的腹部平片（KUB）（28%），其次是KUB和超声联合（22%）。
近三分之一评估尿路结石手术治疗的文章未定义无结石状态；当定义无结石状态时，该定义存在很大差异。此外，用于定义无结石状态的影像学类型存在巨大差异。泌尿外科界应规范泌尿外科文献中无结石结局的报告。
