Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
BJU Int. 2020 Jun;125(6):898-904. doi: 10.1111/bju.15031. Epub 2020 Mar 21.
To compare the safety and effectiveness of using a conventional nephrostomy sheath (NS) vs using a new NS with suction and evacuation functions in minimally invasive percutaneous nephrolithotomy (MPCNL) for the treatment of staghorn stones.
A prospective and randomised study of 60 patients with staghorn stones randomly assigned into two groups of 30 patients. One group underwent MPCNL using conventional NS, whereas the other group underwent MPCNL with suction-evacuation NS (SENS). Patient demographics, stone characteristics, intraoperative data, perioperative data, and surgical results were collected and analysed.
The patient demographics and stone characteristics were similar amongst the two groups. The SENS group had a significantly lower peak and a significantly lower average renal pelvic pressure (RPP) throughout the procedure. The SENS group was more efficient for stone removal and had a much shorter stone treatment time, a lesser use of the stone extractor, and ultimately a higher stone-free rate (SFR). The effects of a lower RPP and shorter stone treatment time translated into less severe postoperative complications as measured per modified Clavien grade.
Using SENS in MPCNL for the treatment of staghorn stones has the advantages of lower RPP, increased effectiveness in stone retrieval, decreased surgery related complications, and an improved SFR.
比较在微创经皮肾镜取石术（MPCNL）中使用传统肾盂造瘘鞘（NS）与使用具有抽吸和清除功能的新型 NS 治疗鹿角结石的安全性和有效性。
前瞻性随机研究了 60 例鹿角结石患者，将其随机分为两组，每组 30 例。一组患者接受传统 NS 的 MPCNL，另一组患者接受具有抽吸清除功能的 NS（SENS）的 MPCNL。收集并分析患者的人口统计学资料、结石特征、术中数据、围手术期数据和手术结果。
两组患者的人口统计学资料和结石特征相似。整个手术过程中，SENS 组的峰值和平均肾盂压力（RPP）明显更低。SENS 组在结石清除方面效率更高，结石治疗时间更短，结石提取器的使用更少，最终结石清除率（SFR）更高。较低的 RPP 和较短的结石治疗时间降低了术后并发症的严重程度，这是按照改良 Clavien 分级来衡量的。
在 MPCNL 中使用 SENS 治疗鹿角结石具有降低 RPP、提高结石清除效果、减少手术相关并发症和提高 SFR 的优点。
