Department of Urology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey -
Department of Urology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
Minerva Urol Nephrol. 2021 Dec;73(6):815-822. doi: 10.23736/S2724-6051.20.04002-3. Epub 2020 Nov 17.
This study aimed to evaluate the possible effect of anterior calyceal stones on the surgical outcomes of percutaneous nephrolithotomy.
Consecutive patients with complex kidney stones from 2012 to 2020 were evaluated retrospectively. In total, 219 patients were divided into 2 groups based on the presence of anterior calyceal stones (group 1; N.=89) or not (group 2; N.=130). The groups were compared in terms of surgical outcomes (i.e., stone-free rate [SFR], operation time, and hemoglobin drop) and complications.
The patient demographics and stone characteristics were similar between the groups. Multiple access was more frequently done in group 1 than it was in group 2 (47.2% vs. 30.8%; P=0.014), and the SFR was lower in group 1 (51.7%) than it was in group 2 (67.7%; P=0.017). Of the anterior calyceal stones in group 1, 42.6% could not be cleaned. However, when excluding patients who have only anterior residual stones from the statistical analysis, the groups had similar SFRs (68.5% vs. 67.7% for group 1 and group 2, respectively).
The presence of complex kidney stones with anterior calyceal extension are associated with higher residual stones rates in the anterior calyx. Also, it increases multiple access, the operation time, and level of hemoglobin drop.
本研究旨在评估肾盂前结石对经皮肾镜取石术手术结果的可能影响。
回顾性评估了 2012 年至 2020 年期间患有复杂肾结石的连续患者。根据是否存在肾盂前结石（组 1；n=89）将 219 例患者分为 2 组（组 2；n=130）。比较两组的手术结果（即无结石率[SFR]、手术时间和血红蛋白下降）和并发症。
两组患者的人口统计学和结石特征相似。组 1 中多通道手术的频率高于组 2（47.2%对 30.8%；P=0.014），组 1 的 SFR 较低（51.7%对 67.7%；P=0.017）。组 1 中的 42.6%的肾盂前结石无法清除。然而，当将仅存在肾盂前残余结石的患者从统计分析中排除时，两组的 SFR 相似（组 1 和组 2 分别为 68.5%和 67.7%）。
存在肾盂前结石的复杂肾结石与肾盂前结石的残留率较高有关。此外，它还增加了多通道手术、手术时间和血红蛋白下降的程度。
