Muljibhai Patel Urological Hospital-Urology, Nadiad, Gujarat, India.
BJU Int. 2012 Oct;110(8 Pt B):E346-9. doi: 10.1111/j.1464-410X.2012.11089.x. Epub 2012 Apr 4.
To plan a prospective comparative case-control designed study aiming to compare minipercutaneous (miniperc) and retrograde intrarenal surgery (RIRS) for a renal calculus of size 1-2 cm.
A total of 64 cases (32 in each arm) underwent miniperc and RIRS during the study period from March 2009 to April 2011. The primary and secondary outcome objective was stone-free rate and retreatment rate, complications, operation duration, patient visual pain scores, analgesic requirement, haemoglobin drop and hospital stay, respectively.
Miniperc and RIRS had stone clearance rates of 100% and 96.88%, respectively. In the RIRS group, one patient required retreatment at 1 month. Hospital stay (0.24) and intra-operative (0.99) and postoperative complications (0.60) were similar in both groups. Operation duration (P = 0.003) was lower in the miniperc group. Haemoglobin drop (P < 0.001), patient pain and visual analogue scale score (each P < 0.001) at 6, 24 and 48 h, as well as analgesic requirement (P < 0.003), were all lower in the RIRS group.
The stone clearances in both modalities are high and complications are low. RIRS requires a larger operation duration, although it is associated with favourable pain scores and a lower haemoglobin drop.
计划一项前瞻性病例对照设计研究，旨在比较 1-2cm 肾结石的微创经皮肾镜取石术（miniperc）和逆行性肾内手术（RIRS）。
2009 年 3 月至 2011 年 4 月期间，共有 64 例患者（每组 32 例）接受了 miniperc 和 RIRS 治疗。主要和次要结局指标分别为结石清除率和再治疗率、并发症、手术时间、患者视觉疼痛评分、镇痛需求、血红蛋白下降和住院时间。
miniperc 和 RIRS 的结石清除率分别为 100%和 96.88%。在 RIRS 组中，1 例患者在 1 个月时需要再次治疗。两组的住院时间（0.24）、术中（0.99）和术后并发症（0.60）相似。miniperc 组的手术时间（P=0.003）较低。RIRS 组血红蛋白下降（P<0.001）、术后 6、24 和 48 小时患者疼痛和视觉模拟评分（均 P<0.001）以及镇痛需求（P<0.003）均较低。
两种方法的结石清除率均较高，并发症发生率较低。RIRS 需要更长的手术时间，但疼痛评分较低，血红蛋白下降更少。
