Kilicarslan Hakan, Kaynak Yurdaer, Kordan Yakup, Kaygisiz Onur, Coskun Burhan, Gunseren Kadir Omur, Kanat Feyzi Mutlu
Department of Urology, Faculty of Medicine, Uludag University, Bursa, Turkey.
Department of Urology, State Hospital, Eskisehir, Turkey.
Urol J. 2015 Apr 29;12(2):2065-8.
To determine the unfavorable factors, related to lower pole anatomical characteristics (LPACs), influencing the success of retrograde intrarenal surgery (RIRS) for lower pole renal calculi (LPC).
We reviewed the data of 36 patients who underwent RIRS for LPC between October 2012 and October 2013. The infundibulopelvic angle (IPA), infundibular length (IL) and infundibular width (IW) were measured on preoperative intravenous urographies. On follow-up stone-free status was defined as complete clearance at the first month kidney-ureter-bladder X-ray and computed tomography if necessary.
The median stone size was 10 mm (range, 5-35). The stone-free rates according to LPACs at the first month follow-up were 100% (n = 17), 57.9% (n = 11), 90% (n = 18), 62.5% (n = 10), 90.5% (n = 19) and 60% (n = 9) for patients with IPA ≥ 70°, IPA < 70º, IL < 3 cm, IL ≥ 3 cm, IW ≥ 5 mm and IW < 5 mm, respectively. While IPA and IW were associated with success of RIRS for LPC in multivariate analysis (P = .003 and P = .046, respectively), only IW was found to be a significant factor after applying multivariate analysis (P = .05).
The results of our study demonstrated that only IW had a significant effect on the success rate of RIRS for LPC.
确定与下极解剖特征（LPACs）相关的不利因素，这些因素会影响下极肾结石（LPC）逆行肾内手术（RIRS）的成功率。
我们回顾了2012年10月至2013年10月期间36例行RIRS治疗LPC患者的数据。术前静脉肾盂造影测量肾盂漏斗角（IPA）、漏斗长度（IL）和漏斗宽度（IW）。随访时，结石清除状态定义为术后第一个月肾输尿管膀胱X线检查结石完全清除，必要时行计算机断层扫描。
结石中位大小为10mm（范围5 - 35mm）。在第一个月随访时，根据LPACs的结石清除率分别为：IPA≥70°的患者为100%（n = 17），IPA<70°的患者为57.9%（n = 11），IL<3cm的患者为90%（n = 18），IL≥3cm的患者为62.5%（n = 10），IW≥5mm的患者为90.5%（n = 19），IW<5mm的患者为60%（n = 9）。多因素分析显示IPA和IW与LPC的RIRS成功率相关（分别为P = .003和P = .046），但应用多因素分析后仅IW被发现是一个显著因素（P = .05）。
我们的研究结果表明，只有IW对LPC的RIRS成功率有显著影响。
