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逆行性肾内手术与经皮肾镜取石术治疗大于2cm肾结石的比较

Comparison of retrograde intrarenal surgery and percutaneous nephrolithotomy for the treatment of renal stones greater than 2 cm.

作者信息

Karakoç Orhan, Karakeçi Ahmet, Ozan Tunç, Fırdolaş Fatih, Tektaş Cihat, Özkarataş Şehmus Erdem, Orhan İrfan

机构信息

Department of Urology, Fırat University Faculty of Medicine, Elazığ, Turkey.

出版信息

Turk J Urol. 2015 Jun;41(2):73-7. doi: 10.5152/tud.2015.97957.

Abstract

OBJECTIVE

To evaluate the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of kidney stones greater than 2 cm and to compare its results with those of percutaneous nephrolithotomy (PCNL).

MATERIALS AND METHODS

We retrospectively analyzed a total of 143 patients: 86 patients (53 males and 33 females) who underwent PCNL and 57 patients (37 males and 20 females) who underwent RIRS between October 2009 and October 2013.

RESULTS

The mean duration of operation was 100.26±33.26 min in the RIRS group and 75.55±21.5 min in the PCNL group (p<0.001). The hospital stay was significantly shorter in the RIRS group (1.56±0.8 vs. 4.57±2.1 days in the RIRS and PCNL groups, respectively; p<0.001). Stone-free rates after one session were 66.6% and 91.8% of the RIRS and PCNL groups, respectively. The stone-free rate of the RIRS group improved to 87.7% after the second session. Blood transfusions were required in two patients in the PCNL group. Complication rates were higher in the PCNL group.

CONCLUSION

This study revealed that RIRS can be an alternative to PCNL in the treatment of kidney stones with a diameter of 2-4 cm especially in patients with comorbidities.

摘要

目的

评估逆行肾内手术(RIRS)治疗直径大于2cm肾结石的安全性和有效性,并将其结果与经皮肾镜取石术(PCNL)的结果进行比较。

材料与方法

我们回顾性分析了2009年10月至2013年10月期间的143例患者:86例(53例男性和33例女性)接受了PCNL,57例(37例男性和20例女性)接受了RIRS。

结果

RIRS组的平均手术时间为100.26±33.26分钟,PCNL组为75.55±21.5分钟(p<0.001)。RIRS组的住院时间明显更短(分别为1.56±0.8天和4.57±2.1天;p<0.001)。单次手术后RIRS组和PCNL组的结石清除率分别为66.6%和91.8%。第二次手术后RIRS组的结石清除率提高到87.7%。PCNL组有两名患者需要输血。PCNL组的并发症发生率更高。

结论

本研究表明,RIRS可作为治疗直径2-4cm肾结石的替代方法,特别是对于合并症患者。

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