Sari Sercan, Ozok Hakki Ugur, Cakici Mehmet Caglar, Ozdemir Harun, Bas Okan, Karakoyunlu Nihat, Sagnak Levent, Senturk Aykut Bugra, Ersoy Hamit
Department of Urology,Sarikamis State Hospital, Kars, Turkey.
Department of Urology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Urol J. 2017 Jan 18;14(1):2949-2954.
In this retrospective study, we aimed to compare the outcomes in patients who have been treated withpercutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) on renal stones ≥ 2 cm size.
We evaluated patients who underwent PNL or RIRS for renal stones ≥ 2 cm size betweenNovember 2011 and November 2014. Stone size, operation, fluoroscopy and hospitalization time, success rates,stone-free rates and complication rates were compared in both groups. Patients were followed for three months.
254 patients were in the PNL Group. 185 patients were in the RIRS Group. The mean age was 46.88 and48.04 years in PNL and RIRS groups, respectively.The patient and stone characteristics (age, gender, Body Mass Index, kidney anomaly, SWL history and stoneradioopacity) were similar between two groups.The mean stone size preoperatively was significantly larger in patients who were treated with PNL (26.33mm.vs24.04mm.; P = .006). In the RIRS group, the mean stone number was significantly higher than PNL group (P <.001).The mean operative, fluoroscopy and hospitalization time were significantly higher in PNL group (P < .001). Thestone-free rate was 93.3% for the PNL group and 73.5% for the RIRS group after first procedure (P < .001). Nomajor complication (Clavien III-V) occurred in the RIRS group.
Although the primary treatment method for renal stones ≥ 2cm size is PNL, serious complicationscan be seen. Therefore, RIRS can be an alternative treatment option in the management of renal stones ≥2 cm size.
在这项回顾性研究中，我们旨在比较接受经皮肾镜取石术（PNL）和逆行肾内手术（RIRS）治疗的肾结石≥2 cm患者的治疗效果。
我们评估了2011年11月至2014年11月期间因肾结石≥2 cm而接受PNL或RIRS治疗的患者。比较两组患者的结石大小、手术方式、透视时间和住院时间、成功率、结石清除率及并发症发生率。对患者进行了为期三个月的随访。
PNL组有254例患者，RIRS组有185例患者。PNL组和RIRS组的平均年龄分别为46.88岁和48.04岁。两组患者的患者及结石特征（年龄、性别、体重指数、肾脏异常、体外冲击波碎石史和结石不透X线程度）相似。接受PNL治疗的患者术前平均结石大小明显更大（26.33mm对24.04mm；P = 0.006）。RIRS组的平均结石数量明显高于PNL组（P < 0.001）。PNL组的平均手术时间、透视时间和住院时间明显更长（P < 0.001）。首次手术后PNL组的结石清除率为93.3%，RIRS组为73.5%（P < 0.001）。RIRS组未发生严重并发症（Clavien III - V级）。
虽然≥2cm肾结石的主要治疗方法是PNL，但可能会出现严重并发症。因此，RIRS可作为≥2cm肾结石治疗的替代选择。
