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一项关于软性输尿管肾镜治疗肾结石的前瞻性欧洲多中心研究。

A prospective multicenter European study on flexible ureterorenoscopy for the management of renal stone.

作者信息

Berardinelli Francesco, Proietti Silvia, Cindolo Luca, Pellegrini Fabrizio, Peschechera Roberto, Derek Hennessey, Dalpiaz Orietta, Schips Luigi, Giusti Guido

机构信息

Dipartimento di Urologia, "S. Pio da Pietrelcina" Hospital, Vasto (CH), Italia.

Centro di pietra presso il Dipartimento di Urologia, Humanitas centro clinico e di ricerca, Rozzano, Italia.

出版信息

Int Braz J Urol. 2016 May-Jun;42(3):479-86. doi: 10.1590/S1677-5538.IBJU.2015.0528.

Abstract

PURPOSE

The aim of this study was to describe the outcomes and the complications of retrograde intrarenal surgery (RIRS) for renal stones in a multi-institutional working group.

MATERIALS AND METHODS

From 2012 to 2014, we conducted a prospective study including all RIRS performed for kidney stones in 4 European centers. Demographic information, disease characteristics, and perioperative and postoperative data were gathered. Patients and stone data, procedure characteristics, results and safety outcomes were analyzed and compared by descriptive statistics. Complications were reported using the standardized Clavien system.

RESULTS

Three hundred and fifty-six patients underwent 377 RIRS with holmium laser lithotripsy for renal stones. The RIRS was completed in all patients with a mean operative time of 63.5 min. The stone-free status was confirmed endoscopically and through fluoroscopic imaging after the first procedure in 73.6%. The second procedure was performed in twenty patients (5.6%) achieving an overall stone free rate of 78.9%. The overall complication rate was 15.1%. Intra-operative and post-operative complications were seen in 24 (6.7%) and 30 (8.4%) cases, respectively.

CONCLUSIONS

RIRS is a minimally invasive procedure with good results in terms of stone-free and complications rate.

摘要

目的

本研究的目的是描述一个多机构工作组中逆行性肾内手术(RIRS)治疗肾结石的结果及并发症。

材料与方法

2012年至2014年,我们进行了一项前瞻性研究,纳入了4个欧洲中心所有因肾结石进行的RIRS手术。收集了人口统计学信息、疾病特征以及围手术期和术后数据。通过描述性统计分析和比较患者及结石数据、手术特征、结果和安全性结果。使用标准化的Clavien系统报告并发症。

结果

356例患者接受了377次使用钬激光碎石术的RIRS治疗肾结石。所有患者的RIRS手术均完成,平均手术时间为63.5分钟。首次手术后,73.6%的患者通过内镜及透视成像证实结石清除。20例患者(5.6%)进行了第二次手术,总体结石清除率达到78.9%。总体并发症发生率为15.1%。术中及术后并发症分别见于24例(6.7%)和30例(8.4%)。

结论

RIRS是一种微创手术,在结石清除率和并发症发生率方面效果良好。

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