Department of Urology, University Hospital Southampton, Southampton, UK.
Department of Urology, Royal Preston Hospital, Preston, UK.
Eur Urol Focus. 2019 Nov;5(6):1127-1134. doi: 10.1016/j.euf.2018.04.002. Epub 2018 Apr 12.
Day case or ambulatory percutaneous nephrolithotomy (PCNL) has risen over the last few years with the aim of discharging patients within 24h.
We perform a systematic review of literature to evaluate the outcomes of day-case PCNL surgery.
A Cochrane style search was performed and the following bibliographic databases were accessed: PubMed, Science Direct, Scopus, and Web of Science. This was carried out in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. All studies in the English language reporting on PCNL patients discharged within 24h were included.
Based on the literature search of 97 articles, nine (502 patients) met the inclusion criteria (mean age: 47 yr), with a mean stone size of 20.5mm. The mean operating time was 66min, and over a mean hospital stay of 17.5h, the stone-free rate was 95%. The overall complication rate was 13.5%; the vast majority of these complications were Clavien I-II complications, with a readmission rate of 3%.
Day-case PCNL is a safe and feasible strategy in carefully selected cases. However, for its success, detailed planning and adherence to surgical protocol are paramount with strict criteria for inpatient admission and a thorough follow-up plan.
Day-case percutaneous nephrolithotomy procedure seems to be a safe procedure with good outcomes, and low risk of complications and readmissions. Detailed preoperative protocol and planning are paramount, with indications for inpatient admission as well as a thorough follow-up plan.
在过去几年中，日间或门诊经皮肾镜取石术（PCNL）有所增加，其目的是在 24 小时内出院。
我们对文献进行系统评价，以评估日间 PCNL 手术的结果。
按照 Cochrane 风格进行搜索，并访问了以下文献数据库：PubMed、Science Direct、Scopus 和 Web of Science。这是根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行的。所有以 24 小时内出院的 PCNL 患者为对象的英文研究均被纳入。
基于对 97 篇文章的文献搜索，符合纳入标准的有 9 篇（502 例患者）（平均年龄：47 岁），平均结石大小为 20.5mm。平均手术时间为 66 分钟，平均住院时间为 17.5 小时，无石率为 95%。总体并发症发生率为 13.5%；绝大多数并发症为 Clavien I-II 级并发症，再入院率为 3%。
日间 PCNL 在精心挑选的病例中是一种安全可行的策略。然而，要取得成功，需要详细的规划和遵守手术方案，对住院标准和彻底的随访计划有严格的要求。
日间经皮肾镜取石术似乎是一种安全有效的手术，具有良好的结果，并发症和再入院的风险较低。详细的术前方案和计划至关重要，包括住院和彻底随访计划的适应证。
