Department of Urology, Birat Medical College Teaching Hospital, Biratnagar, Morang, Nepal.
JNMA J Nepal Med Assoc. 2022 Dec 1;60(256):1033-1036. doi: 10.31729/jnma.7785.
Retrograde intra-renal surgery using flexible scopes and laser energy is a newer alternative in stone disease treatment armamentarium. It is claimed to be superior to other modalities for stone clearance, complications and hospital stay. The aim of this study was to find out the prevalence of complete stone clearance after retrograde intra-renal surgery among patients with urolithiasis in a tertiary care centre.
This was a descriptive cross-sectional study conducted in the Department of Urology in a tertiary care centre from 15 June 2021 to 14 May 2022 including adult patients with stone size up to 15 mm. Ethical approval was obtained from the Institutional Review Committee (Reference number: IRC-PA-143/2077-78). Convenience sampling was done. The prevalence of complete stone clearance (no residual fragment >4 mm) was calculated. Point estimation and 95% confidence interval were calculated.
Among 42 patients, 36 (85.71%) patients (75.1-96.3, 95% Confidence Interval) achieved complete stone clearance. The mean age was 40.26±14.05 (16-74) years and the stone size was 1.27±0.19 (0.9 -1.5) cm. Similarly, the mean operating time was 51.55±9.34 (40-85) minutes and the hospital stay was 1.33±0.52 (1-3) days. Grade 3 ureteric injury occurred in one case. Residual fragments were seen in 6 cases (14.29%). Sepsis occurred in 4 cases (11.11%).
The prevalence of complete stone clearance was similar among patients undergoing retrograde intra-renal surgery in our study when compared to other studies conducted in similar settings.
laser; miniaturization; postoperative complications.
使用柔性内镜和激光能量的逆行性肾内手术是结石病治疗手段的一种新选择。它被声称在结石清除率、并发症和住院时间方面优于其他方法。本研究的目的是在三级保健中心确定肾结石患者接受逆行性肾内手术后完全结石清除的发生率。
这是一项在三级保健中心泌尿科进行的描述性横断面研究，包括 2021 年 6 月 15 日至 2022 年 5 月 14 日期间接受结石大小达 15 毫米的成人患者。该研究获得了机构审查委员会的伦理批准（参考编号：IRC-PA-143/2077-78）。采用便利抽样法。计算完全结石清除（无残余碎片 >4 毫米）的患病率。计算点估计值和 95%置信区间。
在 42 名患者中，36 名（85.71%）患者（75.1-96.3，95%置信区间）达到完全结石清除。平均年龄为 40.26±14.05 岁（16-74 岁），结石大小为 1.27±0.19 厘米（0.9-1.5 厘米）。同样，平均手术时间为 51.55±9.34 分钟（40-85 分钟），住院时间为 1.33±0.52 天（1-3 天）。一例发生 3 级输尿管损伤。6 例（14.29%）可见残余碎片。4 例（11.11%）发生脓毒症。
与在类似环境中进行的其他研究相比，本研究中接受逆行性肾内手术的患者完全结石清除的发生率相似。
激光；微创化；术后并发症。
