Iqbal Nadeem, Iqbal Sajid, Zareen Nasir, Blair Keron Akintola Ayodele
Nadeem Iqbal, Shifa International Hospital, Islamabad, Pakistan.
Sajid Iqbal, Department of Rehabilitation, Pakistan Navy PNS Hospital, Karachi, Pakistan.
Pak J Med Sci. 2022 Mar-Apr;38(4Part-II):833-837. doi: 10.12669/pjms.38.4.5116.
To appraise the effects of previous history of ineffectual extracorporeal shockwave lithotripsy (SWL) treatment on the execution and end result of percutaneous nephrolithotomy (PCNL).
The study was performed from January 2012 till November 2019 at the urology department at our hospital, a tertiary healthcare center. In total, four hundred and twenty two patients were enrolled in the study. We arranged the study participants into two groups. Group-I comprised of 66 subjects who had undergone failed SWL 12 months prior to PCNL procedure, while Group-II included patients who had no history of previous SWL. Information related to study variables was registered in designated proformas and then processed in SPSS version 16 for the statistical computations.
On the whole, the mean age of patients was 45.25± 14.38 years. While the mean calculus size was 494.80±128.83 mm. The complexity of stones formulated on the basis of Guy's stone score was identical among the two groups. American Society of Anesthesiologists (ASA) class categories were almost similar among the two groups. Stone free rates of 80.30% and 81.74% (p value=0.73) were observed in Group-I and II respectively. Time to create PCNL tract and mean drop in hemoglobin were noted to be significantly higher in Group-I. Complication rates and grades were not being dissimilar among the two groups.
Patients having prior history of unsuccessful SWL history before undertaking the PCNL procedure manifested similar stone free rates and complications rates as those observed in SWL naive cases of PCNL.
评估既往体外冲击波碎石术（SWL）治疗无效的病史对经皮肾镜取石术（PCNL）实施过程及最终结果的影响。
本研究于2012年1月至2019年11月在我院泌尿外科进行，我院为三级医疗中心。总共422例患者纳入研究。我们将研究参与者分为两组。第一组由66名在PCNL手术前12个月SWL治疗失败的受试者组成，而第二组包括既往无SWL病史的患者。与研究变量相关的信息记录在指定的表格中，然后在SPSS 16版中进行处理以进行统计计算。
总体而言，患者的平均年龄为45.25±14.38岁。结石平均大小为494.80±128.83 mm。根据盖伊结石评分制定的结石复杂性在两组中相同。两组间美国麻醉医师协会（ASA）分级类别几乎相似。第一组和第二组的结石清除率分别为80.30%和81.74%（p值=0.73）。第一组建立PCNL通道的时间和血红蛋白平均下降幅度明显更高。两组间并发症发生率和分级并无差异。
在进行PCNL手术前有SWL治疗失败病史的患者，其结石清除率和并发症发生率与PCNL初治患者相似。
