Kallidonis P, Vagionis A, Vrettos T, Adamou K, Pagonis K, Ntasiotis P, Callas G A, Tanaseskou L, Al Aown A M, Liatsikos E
Department of Urology, University Hospital of Patras, Patras, Greece.
Department of Anesthesiology and ICU, University Hospital of Patras, Patras, Greece.
World J Urol. 2021 Apr;39(4):1241-1246. doi: 10.1007/s00345-020-03267-z. Epub 2020 May 29.
This study aims to evaluate the non-papillary puncture for mini-PCNL in terms of safety and efficacy.
A total number of 32 patients were subjected to mini-PCNL by the performance of non-papillary punctures over 6 months. One-step track dilation to 22 Fr took place in all cases. An 18 Fr nephroscope (Slender, Karl Storz GmbH, Germany) and an ultrasound lithotripter (Lithoclast Master, EMS S.A, Switzerland) with 9.9 Fr probe was used. Demographics and perioperative data are prospectively collected from an institutional board-approved database and the presented data were retrospectively collected.
The average cumulative stone size was 23.53 ± 6.6 mm. Mean operative time was 44.6 ± 13.44 min and primary stone-free rate after PCNL was 96% and 85.7% for single and multiple access, respectively. Second access was performed in seven cases, all of which had multiple stones. Mean hemoglobin drop was 1.23 ± 0.88 gr/dL. The patients stayed 2.56 ± 0.98 days in the hospital. Overall complication rate was 9.37%, without encountering any severe bleeding complication.
Using non-papillary access for mini-PCNL did not result in significant blood loss and need for transfusions. The respective data were directly comparable to contemporary literature and the safety of mini-PCNL by a non-papillary approach could be advocated.
本研究旨在评估微创经皮肾镜取石术（mini-PCNL）非乳头穿刺的安全性和有效性。
在6个月内，共有32例患者接受了mini-PCNL非乳头穿刺手术。所有病例均采用一步法将通道扩张至22F。使用18F肾镜（德国卡尔史托斯公司的纤细肾镜）和配备9.9F探头的超声碎石机（瑞士EMS公司的Lithoclast Master）。人口统计学和围手术期数据从机构委员会批准的数据库中前瞻性收集，所呈现的数据为回顾性收集。
平均累积结石大小为23.53±6.6mm。平均手术时间为44.6±13.44分钟，PCNL术后单次穿刺和多次穿刺的一期结石清除率分别为96%和85.7%。7例患者进行了二次穿刺，均为多发结石。平均血红蛋白下降1.23±0.88g/dL。患者住院时间为2.56±0.98天。总体并发症发生率为9.37%，未出现任何严重出血并发症。
mini-PCNL采用非乳头入路不会导致大量失血和输血需求。相应数据与当代文献直接可比，可提倡采用非乳头入路进行mini-PCNL的安全性。
