Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Institute of Urology, The First Affiliated Hospital of Guangzhou Medical University, 1 Kangda Road, Haizhu District, Guangzhou, 510230, Guangdong, China.
World J Urol. 2021 Mar;39(3):929-934. doi: 10.1007/s00345-020-03263-3. Epub 2020 May 26.
In the present prospective randomized controlled trial (RCT), enhanced-SMP (eSMP) and conventional Chinese mini-PCNL (mPCNL) were compared to test the low renal pelvic pressure (RPP) and high stone removal efficiency in eSMP.
Hundred patients with 2-5 cm renal calculus were enrolled. Renal pelvic pressure, operation time, lithotripsy time, removed stone volume, and complications were compared between eSMP and mPCNL statistically.
There was no significant difference in removed stone volume between mPCNL and eSMP (8.09 ± 3.36 vs. 7.88 ± 3.07 mm, t = 0.320, p = 0.750), lithotripsy time in mPCNL was longer than eSMP (49.6 ± 19.5 vs. 34.9 ± 14.2 min, t = 4.152, p < 0.001), thus stone removal efficiency was higher in eSMP (13.71 ± 1.18 vs. 9.82 ± 1.24 mm/h, t = 15.499, p < 0.001). Intra-operative RPP in mPCNL was higher than eSMP (17.72 ± 3.33 vs. 12.03 ± 2.37 mmHg, t = 9.524, p < 0.001); accumulated time of backflow status (RPP > 30 mmHg) in mPCNL was longer than eSMP (23.3 ± 16.9 vs. 3.7 ± 4.2 s, t = 7.710, p < 0.001). There was no significant difference in postoperative fever rate between mPCNL and eSMP (12.77% vs. 4.34%, χ = 2.095, p = 0.148), nor final stone-free rate (87.2% vs. 91.3%, χ = 0.401, p = 0.526). Hospital stay in eSMP was shorter than mPCNL (2.54 ± 0.72 vs. 3.00 ± 0.88, t = 2.724, p = 0.008).
Enhanced SMP (eSMP) was safe and effective in the management of 2-5 cm renal calculus. It can keep a lower renal pelvic pressure and a higher stone removal efficiency when compared to conventional Chinese mini-PCNL.
NC03206515.
本前瞻性随机对照试验（RCT）比较了增强型微创经皮肾镜取石术（eSMP）和传统的中国微创经皮肾镜取石术（mPCNL），以验证 eSMP 可降低肾盂压力并提高结石清除效率。
共纳入 100 例 2-5cm 肾结石患者。对 eSMP 和 mPCNL 的肾盂压力、手术时间、碎石时间、结石清除量和并发症进行统计学比较。
mPCNL 和 eSMP 的结石清除量无显著差异（8.09±3.36 vs. 7.88±3.07mm，t=0.320，p=0.750），mPCNL 的碎石时间长于 eSMP（49.6±19.5 vs. 34.9±14.2min，t=4.152，p<0.001），因此 eSMP 的结石清除效率更高（13.71±1.18 vs. 9.82±1.24mm/h，t=15.499，p<0.001）。mPCNL 术中肾盂压力高于 eSMP（17.72±3.33 vs. 12.03±2.37mmHg，t=9.524，p<0.001）；mPCNL 中肾盂压力>30mmHg 的反流状态累积时间长于 eSMP（23.3±16.9 vs. 3.7±4.2s，t=7.710，p<0.001）。mPCNL 和 eSMP 的术后发热率无显著差异（12.77% vs. 4.34%，χ=2.095，p=0.148），最终结石清除率也无显著差异（87.2% vs. 91.3%，χ=0.401，p=0.526）。eSMP 的住院时间短于 mPCNL（2.54±0.72 vs. 3.00±0.88，t=2.724，p=0.008）。
增强型微创经皮肾镜取石术（eSMP）在处理 2-5cm 肾结石方面安全有效。与传统的中国微创经皮肾镜取石术（mPCNL）相比，它可以保持较低的肾盂压力，提高结石清除效率。
NC03206515。
