Department of Urology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, People's Republic of China,
World J Urol. 2013 Oct;31(5):1303-7. doi: 10.1007/s00345-012-0921-2. Epub 2012 Aug 19.
To evaluate the effectiveness and safety of minimally invasive percutaneous nephrolithotomy (mPCNL) without nephrostomy drainage tubes.
We prospectively enrolled 32 eligible patients with kidney stones at our hospital. Patients were randomly assigned to a conventional mPCNL group (ureteric Double-J stents and nephrostomy drainage tubes) or a tubeless mPCNL group (ureteric catheter but no drainage tubes). A single experienced surgeon performed all operations.
At baseline, the two groups had similar age, maximum stone diameter, and gender distribution. There were no significant differences in operation time, presence of postoperative fever, stone clearance, and level of postoperative serum hemoglobin. However, the tubeless mPCNL group had significantly shorter hospital stays (3 vs. 4 days, p = 0.032) and significantly less back pain (5 patients vs. 14 patients, p = 0.003) than the conventional mPCNL group.
No significant differences were found between conventional and tubeless mPCNL in safety issues and stone clearance rate. However, patients treated with tubeless mPCNL had shorter hospitalization stays and were less likely to experience back pain.
评估无肾造瘘管微创经皮肾镜取石术(mPCNL)的有效性和安全性。
我们前瞻性地纳入了我院 32 名符合条件的肾结石患者。患者被随机分配到常规 mPCNL 组(输尿管双 J 支架和肾造瘘管)或无管 mPCNL 组(输尿管导管但无引流管)。由一位经验丰富的外科医生进行所有手术。
基线时,两组患者的年龄、最大结石直径和性别分布相似。手术时间、术后发热、结石清除率和术后血清血红蛋白水平无显著差异。然而,无管 mPCNL 组的住院时间(3 天 vs. 4 天,p = 0.032)和腰痛发生率(5 例 vs. 14 例,p = 0.003)明显低于常规 mPCNL 组。
在安全性问题和结石清除率方面,常规 mPCNL 和无管 mPCNL 之间没有显著差异。然而,接受无管 mPCNL 治疗的患者住院时间更短,腰痛发生率更低。