Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou, China.
Department of Surgery, Faculty of Medicine, University of Hong Kong, Hong Kong, China.
World J Urol. 2018 Jun;36(6):955-961. doi: 10.1007/s00345-018-2197-7. Epub 2018 Jan 31.
To compare the efficacy and safety of Super-mini percutaneous nephrolithotomy (SMP, F12-F14) and Miniperc (F18) in the treatment of renal stones of 2-4 cm in size.
A prospective comparative analysis of outcomes of patients who underwent SMP and Miniperc for treatment of 2-4 cm renal stones was conducted between July 2014 and January 2017. Demographic data, stone criteria, operative technique, complications, blood transfusion, hemoglobin decrease, stone-free rate (SFR) and length of hospital stay were compared between the two groups. Propensity score-matching (PSM) analysis was performed to further compare the outcomes between the two groups.
79 and 257 patients underwent SMP and Miniperc, respectively. After matching, 73 patients in each group were included. The stone burden was comparable for both groups (3.0 ± 1.1 vs 3.2 ± 0.7 cm, p = 0.577). Mean operation time was not significant different between two groups (p = 0.115), while the hospital stay of SMP was much shorter than Miniperc (2.6 ± 1.4 vs 5.2 ± 1.8, p < 0.0001). Both groups had similar SFRs in postoperative 1 day and at 1 month follow-up (p = 0.326, p = 0.153), while SMP achieved a markedly higher tubeless rate than Miniperc (84.9 vs 47.9%, p < 0.0001). The total complication rate was significantly lower in SMP (16.4 vs 41.1%, p = 0.0001), and the SIRS rate was markedly lower in SMP group (1.4 vs 12.3%, p = 0.009).
SMP is equally effective as Miniperc in the treatment of moderate renal calculi, and has the significant advantage in hospital duration and tubeless rate.
比较超微经皮肾镜碎石术（SMP，F12-F14）与微创经皮肾镜碎石术（Miniperc，F18）治疗 2-4cm 肾结石的疗效和安全性。
对 2014 年 7 月至 2017 年 1 月期间接受 SMP 和 Miniperc 治疗的 2-4cm 肾结石患者的临床资料进行前瞻性对比分析。比较两组患者的一般资料、结石参数、手术方式、并发症、输血、血红蛋白下降、结石清除率（SFR）和住院时间。采用倾向评分匹配（PSM）分析进一步比较两组的疗效。
共纳入 SMP 组 79 例、Miniperc 组 257 例患者。PSM 后每组各纳入 73 例患者。两组结石负荷相似（3.0±1.1cm 比 3.2±0.7cm，p=0.577）。两组手术时间无显著差异（p=0.115），但 SMP 组的住院时间明显短于 Miniperc 组（2.6±1.4d 比 5.2±1.8d，p<0.0001）。两组术后 1d 和 1 个月的 SFR 相似（p=0.326，p=0.153），但 SMP 组无管化率显著高于 Miniperc 组（84.9%比 47.9%，p<0.0001）。SMP 组的总并发症发生率明显低于 Miniperc 组（16.4%比 41.1%，p=0.0001），SIRS 发生率明显低于 Miniperc 组（1.4%比 12.3%，p=0.009）。
SMP 治疗中度肾结石的疗效与 Miniperc 相当，且具有住院时间短、无管化率高的显著优势。
