Ozgor Faruk, Kucuktopcu Onur, Ucpinar Burak, Gurbuz Zafer Gokhan, Sarilar Omer, Berberoglu Ahmet Yalcin, Baykal Murat, Binbay Murat
Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey.
Int Braz J Urol. 2016 Nov-Dec;42(6):1168-1177. doi: 10.1590/S1677-5538.IBJU.2015.0646.
In this study, we aim to evaluate and compare the effectiveness of flexible ureterorenoscopy (f-URS) for solitary and multiple renal stones with < 300 mm2 stone burden. Patients' charts who treated with f-URS for kidney stone between January 2010 and June 2015 were reviewed, retrospectively. Patients with solitary kidney stones (n:111) were enrolled in group 1. We selected 111 patients with multiple kidney stones to serve as the control group and the patients were matched at a 1:1 ratio with respect to the patient's age, gender, body mass index and stone burden. Additionally, patients with multiple stones were divided into two groups according to the presence or abscence of lower pole stones. Stone free status was accepted as complete stone clearence and presence of residual fragments < 2 mm. According to the study design; age, stone burden, body mass index were comparable between groups. The mean operation time was longer in group 2 (p= 0.229). However, the mean fluoroscopy screening time in group 1 and in group 2 was 2.1±1.7 and 2.6±1.5 min, respectively and significantly longer in patients with multiple renal stones (P=0.043). The stone-free status was significantly higher in patients with solitary renal stones after a single session procedure (p=0.02). After third month follow up, overall success rate was 92.7% in Group 1 and 86.4% in Group 2. Our study revealed that F-URS achieved better stone free status in solitary renal stones < 300 mm2. However, outcomes of F-URS were acceptable in patients with multiple stones.
在本研究中,我们旨在评估和比较柔性输尿管肾镜检查(f-URS)对结石负荷<300mm²的单发和多发肾结石的有效性。回顾性分析了2010年1月至2015年6月期间接受f-URS治疗肾结石的患者病历。单发肾结石患者(n = 111)纳入第1组。我们选择111例多发肾结石患者作为对照组,患者在年龄、性别、体重指数和结石负荷方面按1:1比例匹配。此外,多发结石患者根据是否存在下极结石分为两组。结石清除状态定义为结石完全清除且残留碎片<2mm。根据研究设计,两组间年龄、结石负荷、体重指数具有可比性。第2组的平均手术时间较长(p = 0.229)。然而,第1组和第2组的平均透视筛查时间分别为2.1±1.7分钟和2.6±1.5分钟,多发肾结石患者的透视筛查时间明显更长(P = 0.043)。单次手术治疗后,单发肾结石患者的结石清除状态明显更高(p = 0.02)。在第三个月随访后,第1组的总体成功率为92.7%,第2组为86.4%。我们的研究表明,f-URS对结石负荷<300mm²的单发肾结石能取得更好的结石清除状态。然而,f-URS对多发结石患者的治疗效果也是可以接受的。