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评估 10 年完全仰卧位经皮肾镜取石术治疗鹿角形与多发性非鹿角形肾结石的结局。

Evaluating outcomes of complete supine percutaneous nephrolithotomy for staghorn vs multiple non-staghorn renal stones: a 10-year study.

机构信息

Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

World J Urol. 2021 Aug;39(8):3071-3077. doi: 10.1007/s00345-020-03563-8. Epub 2021 Jan 5.

Abstract

PURPOSE

To evaluate the outcomes of complete supine percutaneous nephrolithotomy (csPCNL) for staghorn stones and multiple large non-staghorn stones.

METHODS

The records of 886 patients who underwent csPCNL from September 2009 to October 2019 were considered. Out of them, 201 cases met the eligibility criteria and they were divided into three groups: 63 cases of staghorn, 68 cases of multiple medium (20 mm < diameter ≤ 30 mm) non-staghorn and 70 cases of multiple large non-staghorn (> 30 mm) stones. Almost all outcomes and stone-related factors were analyzed.

RESULTS

There was not any significant difference regarding age, body mass index, history of urinary tract infection, transfusion rate, complication rate, pre and post-surgery serum creatinine, hemoglobin drop and total hospital stay between the three groups. Stone free rate was 98.5% in multiple medium group, 97.1% in multiple large group and 84.1% in staghorn group (P = 0.001). The operation duration was significantly shorter for the multiple medium group (P < 0.001) but it was not significantly different between the multiple large non-staghorn and staghorn group.

CONCLUSION

The results demonstrated that almost all outcomes were not significantly different between the three groups (especially between staghorn and larger non-staghorn ones). These findings reveal that surgeons could choose csPCNL for treatment of staghorn stones and multiple large non-staghorn stones and consider staghorn stones as challenging as multiple large (especially diameter > 30 mm) non-staghorn stones.

摘要

目的

评估完全仰卧位经皮肾镜取石术(csPCNL)治疗鹿角结石和多发性大非鹿角结石的效果。

方法

回顾性分析 2009 年 9 月至 2019 年 10 月期间 886 例行 csPCNL 患者的临床资料。其中 201 例符合纳入标准,分为三组:63 例鹿角结石,68 例多发性中等大小(20mm<直径≤30mm)非鹿角结石,70 例多发性大非鹿角结石(直径>30mm)。分析几乎所有的结果和结石相关因素。

结果

三组间年龄、体重指数、尿路感染史、输血率、并发症发生率、术前和术后血清肌酐、血红蛋白下降和总住院时间无统计学差异。多发性中等大小组结石清除率为 98.5%,多发性大非鹿角结石组为 97.1%,鹿角结石组为 84.1%(P=0.001)。多发性中等大小组的手术时间明显缩短(P<0.001),但与鹿角结石组相比差异无统计学意义。

结论

结果表明,三组间几乎所有结果(尤其是鹿角结石和大非鹿角结石之间)无显著差异。这些发现表明,外科医生可以选择 csPCNL 治疗鹿角结石和多发性大非鹿角结石,并认为鹿角结石与大(尤其是直径>30mm)非鹿角结石一样具有挑战性。

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