Department of Urology, Faculty of Medicine, Medical Centre-University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Department of Urology, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
World J Urol. 2018 Mar;36(3):467-473. doi: 10.1007/s00345-017-2148-8. Epub 2017 Dec 7.
To elucidate the current treatment strategies of LRS in German-speaking Europe. Little is known about the treatment of large renal stones (LRS > 3 cm) in daily urological practice. LRS therapy can be, however, challenging and hazardous.
A 39 item web-based survey was performed among urologists listed by the German, Austrian and Swiss Associations of Urology, addressing professionals treating LRS "on their own" and working in a German-speaking country. Uniparametric descriptions indicated as absolute numbers and percentages without p values, simple linear associations and bubble plots without arithmetic means or bar charts with standard deviation between targeted parameters and percentages were used.
266 of the 6586 responding urologists claimed to treat urinary stones on a regular basis. The majority of them were male (90.2%) and over 50 years old (42.9%). Most stones are treated in non-university hospitals (69.5%). 81.9% of all the institutions treat more than 150 cases/y. Open surgery is still performed in 45.5% of the centres, laparoscopy in 32%. Percutaneous nephrolithotomy (PNL) is the primary treatment option. Antimicrobial strategies vary considerably. Serious complications seem to be rare. However, quite a few responders reported treatment-related deaths. The main limitation is the absolute number of urologists performing LRS treatment, which is unknown.
The German-speaking urologist treating LRS is a male and over 50. Although he performs PNL primarily, he is not averse to open surgery and SWL. He applies guidelines and employs modern equipment. Only antimicrobial strategies are out of line with the international standards.
阐明德语欧洲地区治疗巨大肾结石（LRS>3cm）的当前策略。在日常泌尿外科实践中，人们对治疗大肾结石（LRS>3cm）知之甚少。然而，LRS 的治疗可能具有挑战性和危险性。
对德国、奥地利和瑞士泌尿科协会列出的泌尿科医生进行了一项 39 项的在线调查，调查对象为“自行”治疗 LRS 的专业人员，且这些人员在德语国家工作。采用无 p 值的绝对数字和百分比的单参数描述、简单线性关联和气泡图、目标参数和百分比之间的算术平均值或带有标准差的条形图。
在 6586 名回复泌尿科医生中，有 266 名声称定期治疗尿石症。他们中的大多数是男性（90.2%）且年龄超过 50 岁（42.9%）。大多数结石在非大学医院治疗（69.5%）。81.9%的机构每年治疗超过 150 例。45.5%的中心仍采用开放手术，32%的中心采用腹腔镜手术。经皮肾镜取石术（PNL）是主要的治疗选择。抗菌策略差异很大。严重并发症似乎很少见。但是，相当多的回复者报告了与治疗相关的死亡。主要的限制是进行 LRS 治疗的泌尿科医生的绝对数量未知。
治疗 LRS 的德语泌尿科医生是男性且年龄超过 50 岁。尽管他主要进行 PNL，但他并不反对开放手术和 SWL。他采用指南并使用现代设备。只有抗菌策略不符合国际标准。
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