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亚洲泌尿外科学会泌尿系结石病临床诊疗指南。

The Urological Association of Asia clinical guideline for urinary stone disease.

机构信息

Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

Department of Urology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea.

出版信息

Int J Urol. 2019 Jul;26(7):688-709. doi: 10.1111/iju.13957. Epub 2019 Apr 24.

Abstract

The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline - consisting 43 clinical questions - and overview its key practical issues.

摘要

亚洲泌尿外科学会自 1990 年成立以来,由 25 个成员协会和一个附属成员组成,计划为所有泌尿外科学领域制定亚洲指南。结石病领域是其指南项目中的第三个。由于不同的气候、社会、经济和种族环境,亚洲国家的尿石病临床实践存在很大差异。亚洲泌尿外科学会结石病临床指南委员会成员对尿石病的治疗策略进行了一项监测研究,以更好地了解不同地区的多样性,随后通过 PubMed 和 MEDLINE 数据库对 1966 年至 2017 年的系统文献进行了回顾。根据相关策略,为每个管理项目确定了证据水平和推荐等级。每个临床问题和答案都由所有委员会成员及其同事进行了彻底审查和讨论,并征求了美国泌尿外科学会和欧洲泌尿外科学会的专家代表的建议。然而,我们关注的是亚洲患者的实际护理和我们自己的证据,其中包括最近的手术趋势,如微创经皮肾镜取石术和内镜联合肾内手术。本指南涵盖了结石病的所有领域,从病因到预防复发。在这里,我们简要介绍了指南的第一版——由 43 个临床问题组成——并概述了其关键的实际问题。

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