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标准经皮肾镜碎石术(PCNL)与微通道经皮肾镜碎石术(mini-PCNL)治疗 2-4cm 肾结石的无石率和手术事件的比较:随机对照研究。

Concerns about stone free rate and procedure events of percutaneous nephrolithotripsy (PCNL) for 2-4 cm kidney stones by standard-PCNL vs mini-PCNL- comparative randomised study.

机构信息

Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt.

Department of Urology, Faculty of Medicine, Kasr Alaini Medical School, Cairo University, Cairo, Egypt.

出版信息

BMC Urol. 2023 May 19;23(1):96. doi: 10.1186/s12894-023-01270-1.

Abstract

BACKGROUND

To compare the efficacy and safety of standard percutaneous nephrolithotomy (PCNL) with mini- PCNL for kidney stones 2-4 cm.

METHODS

Eighty patients were enrolled in a comparative study, they were randomly divided into mini-PCNL group (n = 40) and standard-PCNL (n = 40). Demographic characteristics, perioperative events, complications, stone free rate (SFR) were reported.

RESULTS

Both groups showed no significant difference in clinical data about age, stone location, back pressure changes, and body mass index. The mean operative time was (95 ± 17.9 min) in mini-PCNL, and (72.1 ± 14.9 min). Stone free rate were 80% and 85% in mini-PCNL and standard-PCNL respectively. Intra-operative complications, post-operative need for analgesia, hospital stay were significantly higher in standard-PCNL compared to mini-PCNL (85% vs. 80%). The study followed CONSORT 2010 guidelines for reporting parallel group randomization.

CONCLUSION

Mini-PCNL is an effective and safe treatment of kidney stones 2-4 cm, it has the advantage over standard-PCNL being has less intra-operative events, less post-operative analgesia, shorter hospital stay, while operative time and stone free rate are comparable when considering multiplicity, hardness, and site of stones.

摘要

背景

比较标准经皮肾镜碎石术(PCNL)与微通道 PCNL 治疗 2-4cm 肾结石的疗效和安全性。

方法

80 例患者纳入对比研究,随机分为微通道 PCNL 组(n=40)和标准 PCNL 组(n=40)。报道了人口统计学特征、围手术期事件、并发症和结石清除率(SFR)。

结果

两组患者的年龄、结石位置、血压变化和体重指数等临床资料无显著差异。微通道 PCNL 的平均手术时间为(95±17.9)min,标准 PCNL 为(72.1±14.9)min。微通道 PCNL 和标准 PCNL 的结石清除率分别为 80%和 85%。标准 PCNL 的术中并发症、术后需要镇痛和住院时间明显高于微通道 PCNL(85%比 80%)。本研究遵循 CONSORT 2010 报告平行随机分组指南。

结论

微通道 PCNL 是治疗 2-4cm 肾结石的有效且安全的方法,与标准 PCNL 相比,其具有术中事件少、术后镇痛少、住院时间短的优点,而考虑到结石的数量、硬度和位置,手术时间和结石清除率相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd5d/10199612/c039400a565e/12894_2023_1270_Fig1_HTML.jpg

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