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肾积水的存在对微通道经皮肾镜取石术有影响吗?

Does the presence of hydronephrosis have effects on micropercutaneous nephrolithotomy?

作者信息

Karatag Tuna, Buldu Ibrahim, Kaynar Mehmet, Inan Ramazan, Istanbulluoglu Mustafa Okan

机构信息

Department of Urology, Faculty of Medicine, Mevlana University, Konya, 42200, Turkey,

出版信息

Int Urol Nephrol. 2015 Mar;47(3):441-4. doi: 10.1007/s11255-014-0907-7. Epub 2015 Jan 7.

Abstract

PURPOSE

To evaluate the effects of presence of hydronephrosis on micropercutaneous nephrolithotomy (micro-PNL) surgery.

PATIENTS AND METHODS

A retrospective analysis of 112 patients who underwent microperc surgery between December 2012 and April 2014 was performed. Patients were evaluated in two groups according to whether the presence of hydronephrosis. Stone size and location, fluoroscopy and operation time, stone-free rates and patient-related parameters were prospectively recorded into a centralized computer-generated system.

RESULTS

A total of 58 patients in Group 1 with hydronephrosis and 54 patients in Group 2 with no hydronephrosis were analyzed. There was no statistically significant difference in terms of stone sizes and body mass indexes (BMI) in comparison of groups (155.2 ± 93.06 vs. 143.70 ± 70.77 mm(2), p = 0.856 and 27.6 ± 4.2 vs. 26.7 ± 3.2 kg/m(2), p = 0.625). The success rates were similar (91.3 vs. 92.5%, p = 0.341). While the mean operation time and fluoroscopy time in Group 1 were 44.2 ± 23.62 min and 105.3 ± 47 s, it was 38.8 ± 26.4 min and 112.53 ± 68.3 s in Group 2, but there was no statistical difference in comparison of both groups. The mean attempts of percutan puncture were 1.35 ± 0.47 in Group 1 and 1.76 ± 0.31 in Group 2 (p = 0.185). We also found no statistical differences regarding mean hemoglobin change and hospitalization time, respectively (p = 0.685 and p = 0753). In comparison of grades of hydronephrosis, there was no statistically significant difference in subgroups analysis.

CONCLUSIONS

The presence of hydronephrosis does not affect success rates and operative time in micro-PNL procedures significantly. Micropercutaneous nephrolithotomy is technically feasible and efficacious both in hydronephrotic and non-hydronephrotic kidneys.

摘要

目的

评估肾积水的存在对微通道经皮肾镜取石术(微通道经皮肾镜取石术)手术的影响。

患者与方法

对2012年12月至2014年4月期间接受微通道经皮肾镜取石术的112例患者进行回顾性分析。根据是否存在肾积水将患者分为两组。前瞻性地将结石大小和位置、透视时间和手术时间、结石清除率以及患者相关参数记录到一个集中的计算机生成系统中。

结果

共分析了1组58例有肾积水的患者和2组54例无肾积水的患者。两组比较,结石大小和体重指数(BMI)无统计学显著差异(155.2±93.06 vs. 143.70±70.77 mm²,p = 0.856;27.6±4.2 vs. 26.7±3.2 kg/m²,p = 0.625)。成功率相似(91.3% vs. 92.5%,p = 0.341)。1组的平均手术时间和透视时间分别为44.2±23.62分钟和105.3±47秒,2组为38.8±26.4分钟和112.53±68.3秒,但两组比较无统计学差异。1组经皮穿刺的平均次数为1.35±0.47次,2组为1.76±0.31次(p = 0.185)。我们还分别发现平均血红蛋白变化和住院时间无统计学差异(p = 0.685和p = 0.753)。在肾积水分级比较中,亚组分析无统计学显著差异。

结论

肾积水的存在对微通道经皮肾镜取石术的成功率和手术时间无显著影响。微通道经皮肾镜取石术在有肾积水和无肾积水的肾脏中技术上都是可行且有效的。

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