肾积水分级对软性输尿管肾镜逆行性肾内结石手术结石清除率的影响。
The effect of hydronephrosis grade on stone-free rate in retrograde intrarenal stone surgery with flexible ureterorenoscopy.
作者信息
Ergani Batuhan, Ozbilen Mert Hamza, Yalcın Mehmet Yigit, Boyacıoglu Hayal, Ilbey Yusuf Ozlem
机构信息
Beyhekim State Hospital, Urology Clinic Konya, Turkey.
University Of Health Sciences Tepecik Training and Research Hospital Urology Clinic Izmir, Turkey.
出版信息
Am J Clin Exp Urol. 2021 Apr 15;9(2):194-201. eCollection 2021.
OBJECTIVE
Hydronephrosis, which may be caused by kidney stones in the collecting system, may induce permanent flank pain and damage to kidney function. In this study, we aimed to examine whether the presence of hydronephrosis in the patient has an effect on the stone-free rates in flexible ureterorenoscopy (FURS) applications.
METHOD
The study was carried out retrospectively with 164 patients. Stone size was calculated as volume in computed tomography. Preoperative patient demographic data, radiographic stone characteristics, operational findings, complication status and postoperative 1st month results were recorded.
RESULT
The mean stone-free rate was found to be 61.5%. It was determined that age, gender, side, number, size and the Hounsfield Unit of the stone, the presence of preoperative extracorporeal shock wave lithotripsy (ESWL) history and the presence of hydronephrosis and its degree did not affect the stone-free rate. However, it was concluded that preoperative percutaneous nephrolithotomy (PNL) application and prolonged operation time were found to affect statistically significant stone-free rate. In addition, '2' was found to be the cut-off value for hydronephrosis in the receiver operating characteristic analysis.
CONCLUSION
The presence of preoperative hydronephrosis does not decrease the success of FURS. However, it can be expected that the success of FURS will decrease as grade 2 or more severe grade of hydronephrosis. Therefore, we think that other treatment modalities such as ESWL and PNL should be prioritized in patients with grade 2 and more severe grade of hydronephrosis.
目的
肾盂积水可能由集合系统中的肾结石引起，可导致永久性胁腹疼痛和肾功能损害。在本研究中，我们旨在探讨患者是否存在肾盂积水对软性输尿管肾镜检查（FURS）应用中的结石清除率有无影响。
方法
对164例患者进行回顾性研究。通过计算机断层扫描计算结石体积。记录术前患者人口统计学数据、影像学结石特征、手术结果、并发症情况及术后第1个月的结果。
结果
结石清除率平均为61.5%。确定年龄、性别、患侧、结石数量、大小及亨氏单位、术前体外冲击波碎石术（ESWL）史、肾盂积水的存在及其程度均不影响结石清除率。然而，得出结论，术前经皮肾镜取石术（PNL）的应用和较长的手术时间在统计学上显著影响结石清除率。此外，在受试者工作特征分析中，发现“2”是肾盂积水的截断值。
结论
术前存在肾盂积水并不会降低FURS的成功率。然而，可以预期，随着肾盂积水达到2级或更严重程度，FURS的成功率将会降低。因此，我们认为对于2级及更严重程度肾盂积水的患者，应优先考虑ESWL和PNL等其他治疗方式。
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