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俯卧位与巴茨“无侧卧位”改良仰卧位经皮肾镜取石术:配对分析。

Prone versus Barts “flank-free” modified supine percutaneous nephrolithotomy: a match-pair analysis.

机构信息

Department of Urology, University of Health Sciences, Tepecik Education and Research Hospital, İzmir, Turkey

Department of Urology, Ankara City Hospital, Ankara, Turkey

出版信息

Turk J Med Sci. 2021 Jun 28;51(3):1373-1379. doi: 10.3906/sag-2011-21.

Abstract

BACKGROUND/AIM: In this study, we aimed to compare the results of prone and Barts “flank-free” modified supine percutaneous nephrolithotomy (PCNL) operations in our clinic.

MATERIALS AND METHODS

The data from patients that underwent Barts “flank-free” modified supine PCNL (BS-PCNL) (n = 52) between June 2018 and July 2020 and prone PCNL (P-PCNL) (n = 286) between April 2014 and June 2018 were retrospectively evaluated. Of those 286 patients, 104 patients whose sex, age, body mass index, American Society of Anesthesiology score, stone localization, stone size, and hydronephrosis matched the BS-PCNL group in a 1:2 ratio were included in the study. The groups were compared in terms of intraoperative outcome, complication rates, and stone-free rates.

RESULTS

The mean age of all patients (58 females, 98 males) included in the study was 41.8 ± 15.2 years, and the mean body mass index (BMI) was 24.7 ± 2.9 kg/m2. The mean operation time was significantly shorter in the BS-PCNL group than in the P-PCNL group (80.2 ± 15.1 min vs. 92.4 ± 22.7 min and p = 0.01). There was no significant difference between the two groups in terms of fluoroscopy time, intraoperative complications, postoperative complications, and stone-free rates.

CONCLUSION

Our study shows that BS-PCNL is an effective and safe method that significantly reduces the operation time and should be considered as one of the primary treatment options for patients scheduled for PCNL.

摘要

背景/目的:本研究旨在比较我院俯卧位和 Barts“无侧卧位”改良仰卧位经皮肾镜取石术(PCNL)的结果。

材料和方法

回顾性分析 2018 年 6 月至 2020 年 7 月间行 Barts“无侧卧位”改良仰卧位 PCNL(BS-PCNL)(n=52)和 2014 年 4 月至 2018 年 6 月间行俯卧位 PCNL(P-PCNL)(n=286)的患者资料。在 BS-PCNL 组中,按照性别、年龄、体重指数、美国麻醉医师协会评分、结石定位、结石大小和肾积水情况,以 1:2 的比例选取与 P-PCNL 组相匹配的 104 例患者纳入本研究。比较两组患者的术中结果、并发症发生率和结石清除率。

结果

所有纳入研究的患者(58 例女性,98 例男性)的平均年龄为 41.8±15.2 岁,平均体重指数(BMI)为 24.7±2.9kg/m2。BS-PCNL 组的手术时间明显短于 P-PCNL 组(80.2±15.1min 比 92.4±22.7min,p=0.01)。两组患者的透视时间、术中并发症、术后并发症和结石清除率无显著差异。

结论

本研究表明,BS-PCNL 是一种有效且安全的方法,可显著缩短手术时间,应作为 PCNL 患者的主要治疗选择之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3f8/8283509/c25e1d58a3ea/turkjmedsci-51-1373-fig001.jpg

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