Bhardwaj Raghubir, Sinha Harish K, Deb Ratnadip, Mistari Walmik
Urology, Tata Main Hospital, Jamshedpur, IND.
Biomedical Statistics, Tata Main Hospital, Jamshedpur, IND.
Cureus. 2023 Jan 10;15(1):e33597. doi: 10.7759/cureus.33597. eCollection 2023 Jan.
Objective To assess the surgical outcome of supine percutaneous nephrolithotomy (PCNL) in patients with co-morbidities. Materials and methods We retrospectively reviewed the data of 15 patients who underwent supine PCNL at our centre from September 2019 to May 2021. Preoperatively, a complete examination of the patients, along with biochemical and radiological investigations, was done. The data, which included patient demographics, comorbidities, complexity of renal calculi, complications, and stone clearance rate, were collected from the patients' medical records. Results Patients aged between 31 and 70 years were included in the study. The mean (SD) BMI was 26.01 (2.31). Twelve patients (80%) were overweight with a BMI of 25.3 to 29.3 kg/m. The most common comorbidities were diabetes (33.3%) and hypertension (26.7%). In our study, six patients were American Society of Anesthesiologists (ASA) grade 3 (40%), followed by grade 2 in five patients (33.3%), grade 4, and grade 1 in two patients (13.3%) each. The Guy's Stone score was one in nine patients (60%) and two in six patients (40%). Complete clearance was achieved in 13 (86.7%) patients. Two patients (13.3%) had a stone clearance of more than 80%. Data analysis showed that 14 patients (93.3%) had no perioperative complications. Postoperative abdominal distension was noted in one patient (6.7%), which was managed conservatively (Clavien-Dindo grade 1). We did not encounter any cases of organ injury following supine PCNL. Postoperatively, none of our patients received blood transfusions. Conclusion Our study shows that supine PCNL is a good surgical option, especially for high-risk patients with good stone clearance and low complication rates.
目的 评估合并症患者仰卧位经皮肾镜取石术（PCNL）的手术效果。材料与方法 我们回顾性分析了2019年9月至2021年5月在本中心接受仰卧位PCNL的15例患者的数据。术前，对患者进行了全面检查，并进行了生化和影像学检查。从患者病历中收集了包括患者人口统计学、合并症、肾结石复杂性、并发症和结石清除率等数据。结果 纳入研究的患者年龄在31至70岁之间。平均（标准差）体重指数（BMI）为26.01（2.31）。12例患者（80%）超重，BMI为25.3至29.3kg/m²。最常见的合并症是糖尿病（33.3%）和高血压（26.7%）。在我们的研究中，6例患者为美国麻醉医师协会（ASA）3级（40%），其次是5例患者为2级（33.3%），4级和1级各2例（13.3%）。盖氏结石评分9例患者为1分（60%），6例患者为2分（40%）。13例（86.7%）患者结石完全清除。2例患者（13.3%）结石清除率超过80%。数据分析显示，14例患者（93.3%）无围手术期并发症。1例患者（6.7%）出现术后腹胀，经保守治疗（Clavien-Dindo 1级）。仰卧位PCNL后我们未遇到任何器官损伤病例。术后，我们的患者均未接受输血。结论 我们的研究表明，仰卧位PCNL是一种良好的手术选择，特别是对于结石清除率高、并发症发生率低的高危患者。
