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逆行性肾内手术与经皮肾镜取石术治疗大尺寸肾结石(≥4 cm)的比较:单中心回顾性研究

Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy Methods For Management of Big- Sized Kidney Stones(? 4 cm): Single Center Retrospective Study.

作者信息

Karakoyunlu Ahmet Nihat, Cakici Mehmet Caglar, Sari Sercan, Hepsen Emre, Ozok Hakki Ugur, Sagnak Azmi Levent, Topaloglu Hikmet, Senturk Aykut Bugra, Ersoy Hamit

机构信息

Department of Urology, University of Health Sciences , Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.

Department of Urology, University of Health Sciences , Dıskapı Yildirım Beyazit Training and Research Hospital, Ankara, Turkey.

出版信息

Urol J. 2019 Jun 17;16(3):232-235. doi: 10.22037/uj.v0i0.4072.

Abstract

UNLABELLED

Purpose: Management of ? 4 cm sized kidney stone is a rarely seen problem in urology. Few studies are present about this issue. Percutaneous nephrolithotomy(PNL), Retrograde Intrarenal Surgery(RIRS) and open surgery are the methods used in stone management. In our study we aimed to compare RIRS and PNL in the management of ? 4 cm sized kidney stones.

MATERIALS AND METHODS

Among patients who had undergone RIRS and PNL in D?skap? Y?ld?r?m Beyaz?t Train-ing and Research Hospital, 94 patients who had ? 4 cm sized kidney stones were included our study. The demo-graphic, intraoperative and postoperative data of these patients and complications were evaluated retrospectively.

RESULTS

94 patients (67 PNL, 27 RIRS) were in the study. Stone laterality, urinary anomaly and gender were sim-ilar in two groups.(Group PNL(P) and Group RIRS(R)) Stone number were 2.55 ± 1.44 and 2.78 ± 1.42 in Group P and R, respectively. Stone size were 47.06 ± 7.02 and 46.41 ± 6.00 mm. in Group P and R, respectively. The differences between two groups were not statistically significant.(P > .05) In Group P scopy time, hospital stay and stone free rate were higher and operation time was lower than Group R. And the difference was statistically significant(P < .05).

CONCLUSIONS

As a result, PNL is an effective method and operation time is lower than RIRS. Also a second oper-ation for JJ stent taking is lower in PNL . RIRS is a safe method. RIRS has less complications and hospitalization time. They are feasible in treatment of ? 4 cm sized kidney stones.

摘要

未标注

目的:处理直径≥4 cm的肾结石是泌尿外科中少见的问题。关于此问题的研究较少。经皮肾镜取石术(PNL)、逆行肾内手术(RIRS)和开放手术是用于结石处理的方法。在我们的研究中,我们旨在比较RIRS和PNL在处理直径≥4 cm肾结石方面的效果。

材料与方法

在德尼兹利耶尔德勒姆贝亚泽特培训与研究医院接受RIRS和PNL的患者中,94例有直径≥4 cm肾结石的患者被纳入我们的研究。对这些患者的人口统计学、术中及术后数据以及并发症进行回顾性评估。

结果

94例患者(67例行PNL,27例行RIRS)纳入研究。两组的结石位置、泌尿系统异常和性别相似。(PNL组(P组)和RIRS组(R组))P组和R组的结石数量分别为2.55±1.44和2.78±1.42。P组和R组的结石大小分别为47.06±7.02和46.41±6.00 mm。两组之间的差异无统计学意义(P>0.05)。P组的镜检时间、住院时间和结石清除率高于R组,而手术时间低于R组。差异有统计学意义(P<0.05)。

结论

结果显示,PNL是一种有效的方法,手术时间比RIRS短。此外,PNL取出双J管的二次手术率较低。RIRS是一种安全的方法。RIRS并发症更少,住院时间更短。它们在治疗直径≥4 cm的肾结石方面是可行的。

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