Urology, Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
Minimally Invasive Technique and Product Translational Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
Biomed Res Int. 2020 May 14;2020:8052013. doi: 10.1155/2020/8052013. eCollection 2020.
Comparison of outcomes between RIRS with vacuum-assisted ureteral access sheath (V-UAS) and MPCNL in the treatment of renal stone.
28 patients with 2-4 cm renal stone were treated using RIRS with 14/16 F V-UAS. The outcomes were compared to those who underwent MPCNL with 16 F Amplatz sheath using a matched-pair analysis in a 1 : 2 scenario. Matching criteria included stone size, location and laterality, gender, age, BMI, and degree of hydronephrosis. Patients' demographics, perioperative and postoperative characteristics, complications, stone-free rate (SFR), and auxiliary procedures were compared.
Mean operative times for the RIRS and MPCNL groups were 72.4 ± 21.3 minutes and 67.4 ± 25 minutes ( = 0.042). Postoperative pain was significantly less in the RIRS group. The initial SFR was 50% for the RIRS group and 73.2% for the MPCNL group ( = 0.035). The final SFR at postoperative three months improved to 89.3% for the RIRS group and 92.9% for the MPCNL group ( = 0.681). The auxiliary procedure rates were higher in the RIRS group (42.9% vs. 25%, = 0.095). The overall complication rate in the RIRS group was lower, but the significant difference was not found.
In the treatment of 2-4 cm renal stone, using V-UAS in RIRS can improve surgical efficiency with lower postoperative early pain scores. Comparing with MPCNL, its initial SFR was more depressed, and there is still a trend towards requiring more auxiliary procedures to achieve comparable final SFR.
比较 RIRS 联合真空辅助输尿管镜鞘（V-UAS）与 MPCNL 治疗肾结石的疗效。
28 例 2-4cm 肾结石患者采用 14/16F V-UAS 行 RIRS 治疗，通过 1:2 配对分析，将其与采用 16F Amplatz 鞘行 MPCNL 的患者的结果进行比较。匹配标准包括结石大小、位置和侧别、性别、年龄、BMI 和肾积水程度。比较患者的人口统计学、围手术期和术后特征、并发症、结石清除率（SFR）和辅助手术。
RIRS 组和 MPCNL 组的平均手术时间分别为 72.4±21.3 分钟和 67.4±25 分钟（=0.042）。RIRS 组术后疼痛明显较轻。RIRS 组初始 SFR 为 50%，MPCNL 组为 73.2%（=0.035）。RIRS 组术后 3 个月最终 SFR 提高至 89.3%，MPCNL 组提高至 92.9%（=0.681）。RIRS 组辅助手术率较高（42.9%比 25%，=0.095）。RIRS 组总体并发症发生率较低，但差异无统计学意义。
在治疗 2-4cm 肾结石时，RIRS 联合 V-UAS 可提高手术效率，降低术后早期疼痛评分。与 MPCNL 相比，其初始 SFR 较低，仍有更多辅助手术的趋势，以达到可比的最终 SFR。
