Tepecik Training and Research Hospital Urology Clinic, Izmir.
Ege University Faculty of Medicine Anesthesiology and Reanimation Department, Izmir.
Arch Ital Urol Androl. 2022 Jun 29;94(2):195-198. doi: 10.4081/aiua.2022.2.195.
The indications for retrograde intrarenal surgery (RIRS) have greatly increased, however, there is still no consensus on the use of spinal anesthesia (SA) during this procedure. The aim of this study was to evaluate the comparability of surgical outcomes of RIRS performed under SA versus general GA for renal stones.
This was a retrospective, observational study in patients scheduled for RIRS in a single teaching hospital in Turkey. Inclusion criteria were age > 18 years and the presence of single or multiple renal stones. We recorded information concerning the site of lithiasis, the number of calculi, total stone burden, and the presence of concomitant ureteral stones or hydronephrosis. Results were evaluated in terms of surgical outcome, intraoperative and postoperative complications. Patients were followed-up until day 90 from discharge.
The data of 502 patients, 252 in GA group and 250 in SA group, were evaluated. The stone-free rate was 81% in the GA group and 85% in the SA group (p = 0.12). No cases of conversion from SA to GA were recorded. Complication rates were similar in the 2 groups (19% vs 14.5%, p = 0.15).
In our cohort, RIRS performed under SA and GA was equivalent in terms of surgical results and complications.
逆行性肾内手术（RIRS）的适应证大大增加，然而，对于该手术中是否使用脊髓麻醉（SA）仍然没有共识。本研究的目的是评估 SA 与全身麻醉（GA）在治疗肾结石的 RIRS 中的手术结果的可比性。
这是在土耳其的一家教学医院进行的回顾性、观察性研究，纳入了接受 RIRS 治疗的年龄>18 岁的肾结石患者。纳入标准为单一或多发肾结石。我们记录了结石部位、结石数量、结石总负荷、同时存在的输尿管结石或肾积水等信息。结果根据手术结果、术中及术后并发症进行评估。患者在出院后第 90 天进行随访。
共评估了 502 例患者的数据，其中 252 例在 GA 组，250 例在 SA 组。GA 组的无结石率为 81%，SA 组为 85%（p=0.12）。没有从 SA 转为 GA 的病例。两组的并发症发生率相似（19%比 14.5%，p=0.15）。
在我们的队列中，SA 和 GA 下进行的 RIRS 在手术结果和并发症方面是等效的。
