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超微经皮肾镜取石术在肾结石治疗中的作用。

The role of ultra-mini percutaneous nephrolithotomy in the treatment of kidney stones.

作者信息

Tepeler Abdulkadir, Başıbüyük İsmail, Tosun Muhammed, Armağan Abdullah

机构信息

Department of Urology, Bezmialem Vakif University School of Medicine, İstanbul, Turkey.

出版信息

Turk J Urol. 2016 Dec;42(4):261-266. doi: 10.5152/tud.2016.32644.

Abstract

OBJECTIVE

In our study we aimed to evaluate outcomes of ultra-mini-percutaneous nephrolithotomy (UMP) performed for the treatment of kidney stones.

MATERIAL AND METHODS

Between October 2014 and September 2015, a single surgeon performed UMP on a total of 49 consecutive patients with symptomatic kidney stones at our center. Pregnants, anticogulant users, patients with bleeding diathesis pyonephrosis, and partial/complete staghorn stones were excluded from the study. Patient characteristics, operative data and postoperative outcomes were assessed in detail.

RESULTS

The UMP was performed on 50 (34 right/16 left) renal units of the 48 (28 male/20 female) patients included in this study. The mean age and body mass index was 36.5 (2-83) years and 26.2 (17.6-32.8) kg/m, respectively. Mean stone size was calculated as 22.2 (10-55) mm. The mean durations of the operations and fluoroscopic examination were calculated as 65.4 (20-120) minutes and 89.4 (9-322) seconds, respectively. The mean duration of hospitalization was 1.4 (1-5) days. In 52% of the patients the procedure was terminated tubeless. Mean hemoglobin drop was 0.6 (0-3) g/dL. Our series experienced a 10% complication rate. The UMP procedure was successful in 96% of the renal units at the 1 month control visit assessment.

CONCLUSION

The outcomes of our study have demonstrated that UMP is an effective and safe treatment modality, especially in the treatment of medium-sized renal calculi.

摘要

目的

在我们的研究中,旨在评估用于治疗肾结石的超微经皮肾镜取石术(UMP)的疗效。

材料与方法

2014年10月至2015年9月期间,在我们中心,由一位外科医生对49例有症状肾结石的连续患者进行UMP手术。孕妇、抗凝剂使用者、有出血倾向的患者、脓肾患者以及部分/完全鹿角形结石患者被排除在研究之外。详细评估了患者特征、手术数据和术后结果。

结果

本研究纳入的48例(28例男性/20例女性)患者的50个肾单位(34个右侧/16个左侧)接受了UMP手术。平均年龄和体重指数分别为36.5(2 - 83)岁和26.2(17.6 - 32.8)kg/m²。平均结石大小经计算为22.2(10 - 55)mm。手术和透视检查的平均时长分别经计算为65.4(20 - 120)分钟和89.4(9 - 322)秒。平均住院时长为1.4(1 - 5)天。52%的患者手术以无管方式结束。平均血红蛋白下降0.6(0 - 3)g/dL。我们的系列病例并发症发生率为10%。在1个月的对照访视评估中,UMP手术在96%的肾单位中成功。

结论

我们的研究结果表明,UMP是一种有效且安全的治疗方式,尤其在治疗中等大小肾结石方面。

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J Urol. 2016 Mar;195(3):741-6. doi: 10.1016/j.juro.2015.07.123. Epub 2015 Oct 18.
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4
Ultra-mini-percutaneous nephrolithotomy in pediatric nephrolithiasis: both low pressure and high efficiency.
J Pediatr Urol. 2015 Oct;11(5):253.e1-6. doi: 10.1016/j.jpurol.2015.03.012. Epub 2015 Apr 28.
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BJU Int. 2013 Nov;112(7):1046-9. doi: 10.1111/bju.12193. Epub 2013 Jul 11.
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