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经皮肾镜取石术、开放手术或内镜取石术治疗肾结石后行 RIRS 是否安全有效?单中心回顾性研究。

Is RIRS Safe and Efficient In Patients With Kidney Stones Who Had Previous Open, Endoscopic, or Percutaneous Kidney Stone Surgery? One Center Retrospective Study.

机构信息

Department of Urology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Reserch Hospital, Ankara,Turkey.

Department of Urology, Bozok University Faculty of Medicine,Yozgat,Turkey.

出版信息

Urol J. 2020 May 16;17(3):228-231. doi: 10.22037/uj.v0i0.4950.

Abstract

PURPOSE

In our study, we assessed the efficiency and reliability of retrograde intrarenal surgery secondary to open surgery for kidney stone treatment. Moreover, we compared the efficiency and safety of retrograde intrarenal surgery for the patients with previous history of open surgery, percutaneous nephrolithotomy, secondary retrograde intrarenal surgery (RIRS) and primary RIRS.

MATERIALS AND METHODS

Data was retrospectively reviewed. Patients who had kidney anomalies, who had been stented due to ureteral stricture in the operation and who were < 18 years old, were excluded. There were 30 patients who underwent RIRS secondary to open surgery. The demographic and stone characteristic as well as intraoperative and postoperative data of the patients were recorded. 30 patients with similar demographic and stone characteristics to those patients were selected by match pairing method from patients who had previous PNL, RIRS history and had undergone primary RIRS. A total of 120 patients, in total 4 groups, were included in the study.

RESULTS

Statistically significant difference was detected among the groups with regards to shock wave lithotripsy history and preoperative JJ stent rate. There was no statistically significant difference in terms of stone characteristics, intraoperative and postoperative data.

CONCLUSION

RIRS is an efficient and safe method for kidney stone treatment of the patients with previous history of open surgery, percutaneous nephrolithotomy and retrograde intrarenal surgery. It has a similar efficiency and safety for the patients who have undergone retrograde intrarenal surgery. This is the first study that compares the patients especially  with different previous surgery methods.

摘要

目的

在我们的研究中,我们评估了开放手术治疗肾结石后逆行肾盂内手术的效率和可靠性。此外,我们比较了有开放手术、经皮肾镜取石术、二次逆行肾盂内手术(RIRS)和初次 RIRS 史的患者行逆行肾盂内手术的效率和安全性。

材料和方法

回顾性分析数据。排除存在肾畸形、术中因输尿管狭窄而置管以及年龄<18 岁的患者。共有 30 例患者因开放手术而行 RIRS。记录患者的人口统计学和结石特征以及术中、术后数据。通过匹配配对法从有经皮肾镜取石术、RIRS 史和初次 RIRS 史的患者中选择 30 名具有相似人口统计学和结石特征的患者。总共纳入 120 名患者,分为 4 组。

结果

各组间在冲击波碎石史和术前 JJ 支架率方面存在显著差异。在结石特征、术中及术后数据方面无统计学差异。

结论

RIRS 是治疗有开放手术、经皮肾镜取石术和逆行肾盂内手术史的肾结石患者的有效且安全的方法。对于行逆行肾盂内手术的患者,其具有相似的效率和安全性。这是第一项比较不同既往手术方法患者的研究。

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