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逆行性肾内手术及微通道经皮肾镜取石术治疗直径小于2厘米的肾结石

Retrograde intrarenal surgery and micro-percutaneous nephrolithotomy for renal lithiasis smaller than 2 CM.

作者信息

Cepeda M, Amón J H, Mainez J A, de la Cruz B, Rodríguez V, Alonso D, Martínez-Sagarra J M

机构信息

Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, España.

Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, España.

出版信息

Actas Urol Esp. 2017 Oct;41(8):516-521. doi: 10.1016/j.acuro.2017.02.003. Epub 2017 Apr 25.

Abstract

INTRODUCTION

Microperc is the upgraded form of percutaneous nephrolithotomy miniaturization. The aim of this study is to compare prospectively microperc and retrograde intrarenal surgery for the treatment of renal stones smaller than 2 cm.

MATERIAL AND METHODS

A comparative prospective study of both techniques was carried out between January 2014 and June 2015. Thirty-five patients were divided in two groups: Group A, 17 patients treated by retrograde intrarenal surgery and Group B, 18 patients treated by microperc. Stone clearance was assessed using CT scan 3 months after surgery.

RESULTS

Both groups were statistically comparable as demographic variables and stone size was similar (16.76 mm Group A vs 15.72 mm Group B). Success rate, hospital stay and JJ stenting were similar for both groups. There was no statistically significant difference regarding post-operatory complications: 17.64% Group A vs 5.56% Group B (p=0,062), all of them Clavien I and II. Surgical time was statistically different (63.82 min Group A vs 103.24 min Group B) as well as hemoglobin drop (0.62 g/dl Group A and 1.89 g/dl Group B).

CONCLUSION

Microperc is an effective and safe procedure for the treatment of renal lithiasis smaller than 2 cm, which makes it a good alternative to retrograde intrarenal surgery for this stone size. However, more prospective studies that include a larger cohort are necessary to confirm our results.

摘要

引言

微通道经皮肾镜取石术是经皮肾镜取石术小型化的升级形式。本研究的目的是前瞻性比较微通道经皮肾镜取石术和逆行肾内手术治疗小于2cm肾结石的疗效。

材料与方法

2014年1月至2015年6月对这两种技术进行了一项比较前瞻性研究。35例患者分为两组:A组,17例接受逆行肾内手术治疗;B组,18例接受微通道经皮肾镜取石术治疗。术后3个月使用CT扫描评估结石清除情况。

结果

两组在人口统计学变量方面具有统计学可比性,结石大小相似(A组16.76mm vs B组15.72mm)。两组的成功率、住院时间和双J管置入情况相似。术后并发症方面无统计学显著差异:A组为17.64%,B组为5.56%(p=0.062),均为Clavien I级和II级。手术时间有统计学差异(A组63.82分钟 vs B组103.24分钟),血红蛋白下降情况也有差异(A组0.62g/dl,B组1.89g/dl)。

结论

微通道经皮肾镜取石术是治疗小于2cm肾结石的一种有效且安全的方法,对于这种结石大小,它是逆行肾内手术的一个良好替代方案。然而,需要更多纳入更大样本量的前瞻性研究来证实我们的结果。

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