Falahatkar Siavash, Mokhtari Gholamreza, Amin Atiyeh, Kazemnezhad Ehsan, Esmaeili Samaneh, Herfeh Nadia Rastjou, Falahatkar Reza
Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Turk J Urol. 2017 Dec;43(4):490-496. doi: 10.5152/tud.2017.14477. Epub 2017 Dec 1.
This study compared the stone opacity effect in patients who had radiopaque and radiolucent stones in percutaneous nephrolithotomy (PCNL) results.
The medical records of 171 complete supine PCNL procedures were gathered. Patients were categorized into two groups: those with radiopaque (n=141) and those with radiolucent (n=30) stones. Kidney, ureter and bladder x-ray was done a day after PCNL and Ultrasound imaging was done two weeks later to evaluate the stone free rate. A stone free result was defined as having less than 4 mm residual stone size. Outcome parameters were compared by univariate analysis and those which were significantly different between the two groups were assessed by multivariate binary logistic regression analysis.
There were no significant differences in age, sex, body mass index, hypertension, diabetes mellitus, pre-surgery hemoglobin, pre-surgery serum creatinine, stone and also surgery-related parameters between the two groups. Stone free rate, surgery time, complication-related parameters, hemoglobin drop, serum creatinine and glomerular filtration rate (GFR) changes were similar in both groups based on univariate analysis. The radiopaque group had higher post-surgery GFR (p=0.04) and longer hospital stay (p=0.009). However, opacity had no effect on these outcomes after multivariate analysis. Higher post-surgery GFR was seen in patient with higher GFR before surgery (p<0.0001). Also, higher hemoglobin before surgery was correlated with less hospital stay (p=0.001).
The complete supine percutaneous nephrolithotomy outcomes are similar in patients with radiopaque and radiolucent stones.
本研究比较了经皮肾镜取石术（PCNL）结果中不透光结石和透光结石患者的结石显影效果。
收集了171例完全仰卧位PCNL手术的病历。患者分为两组：不透光结石组（n = 141）和透光结石组（n = 30）。PCNL术后一天进行肾脏、输尿管和膀胱X线检查，两周后进行超声成像以评估无结石率。无结石结果定义为残余结石大小小于4mm。通过单因素分析比较结果参数，两组间有显著差异的参数通过多因素二元逻辑回归分析进行评估。
两组在年龄、性别、体重指数、高血压、糖尿病、术前血红蛋白、术前血清肌酐、结石以及手术相关参数方面均无显著差异。根据单因素分析，两组的无结石率、手术时间、并发症相关参数、血红蛋白下降、血清肌酐和肾小球滤过率（GFR）变化相似。不透光结石组术后GFR较高（p = 0.04），住院时间较长（p = 0.009）。然而，多因素分析后结石显影对这些结果无影响。术前GFR较高的患者术后GFR也较高（p < 0.0001）。此外，术前血红蛋白较高与住院时间较短相关（p = 0.001）。
不透光结石和透光结石患者的完全仰卧位经皮肾镜取石术结果相似。
