Haggag Yasser M, Morsy Gamal, Badr Magdy M, Al Emam Abdel Baset A, Farid Mourad, Etafy Mohamed
Al-Azhar Urology Department, Assiut, Egypt;
Can Urol Assoc J. 2013 Mar-Apr;7(3-4):E171-5. doi: 10.5489/cuaj.490.
The aim of the study is to investigate whether laparoscopic pyelolithotomy (LPL) could be used to manage large renal pelvic stones, generally considered excellent indications for percutaneous nephrolithotomy (PNL).
This study was performed from May 2009 to March 2012 at Al-Azhar University Hospitals (Assiut and Cairo), Egypt. It included two groups of patients with large renal pelvic stones; only patients with stones 2.5 cm(2) or greater were included. Group 1 included 40 patients treated by PNL and Group 2 included 10 patients treated by LPL. The differences between the two procedures were compared and analyzed.
There was no difference between the two groups regarding patient demographics and stone size. There was a statistically significant difference between the groups regarding mean estimated blood loss (65 ± 12.25 [range: 52.75-77.25] vs. 180 ± 20.74 [range: 159.26-200.74] mL, p ≤ 0001), mean hospital stay (2.3 ± 0.64 [range: 1.66-2.94] vs. 3.7 ± 1.4 [range: 2.3-5.1] days, p ≤ 0.006), rate of postoperative blood transfusion (0% vs. 4.8%, p ≤ 0.0024), and stone-free rate (80% vs. 78.6%, p ≤ 0.23). The mean operative time was significantly longer in Group 2 (LPL) (131 ± 22.11 [range: 108.89-153.11) vs. 51.19 ± 24.39 [range: 26.8-75.58] min, p ≤ 0001), respectively.
Although PNL is the standard treatment in most cases of renal pelvic stones, LPL is another feasible surgical technique for patients with large renal pelvic stones.
本研究旨在探讨腹腔镜肾盂切开取石术（LPL）是否可用于处理通常被认为是经皮肾镜取石术（PNL）极佳适应证的大型肾盂结石。
本研究于2009年5月至2012年3月在埃及艾资哈尔大学医院（阿斯尤特和开罗）进行。研究纳入了两组大型肾盂结石患者；仅纳入结石直径2.5厘米及以上的患者。第1组包括40例行PNL治疗的患者，第2组包括10例行LPL治疗的患者。对两种手术方法之间的差异进行了比较和分析。
两组患者的人口统计学特征和结石大小无差异。两组之间在平均估计失血量（65±12.25[范围：52.75 - 77.25]对180±20.74[范围：159.26 - 200.74]毫升，p≤0.001）、平均住院时间（2.3±0.64[范围：1.66 - 2.94]对3.7±1.4[范围：2.3 - 5.1]天，p≤0.006）、术后输血率（0%对4.8%，p≤0.0024）和结石清除率（80%对78.6%，p≤0.23）方面存在统计学显著差异。第2组（LPL）的平均手术时间明显更长（分别为131±22.11[范围：108.89 - 153.11]对51.19±24.39[范围：26.8 - 75.58]分钟，p≤0.001）。
虽然PNL是大多数肾盂结石病例的标准治疗方法，但LPL对于大型肾盂结石患者来说是另一种可行的手术技术。
