Napitupulu Tiopan, Hardja Yosua, Susanto Martin, Hutahaean Grace Dumamawarni, Riantri Ika, Sutapa Hendra, Rachman Yusuf, Siahaan Andre Marolop Pangihutan
Universitas Sumatera Utara, Faculty of Medicine, Medan, Indonesia.
University of Padjadjaran, Department of Urology, Bandung, Indonesia.
Medeni Med J. 2023 Jun 20;38(2):120-127. doi: 10.4274/MMJ.galenos.2023.85688.
The preferred therapy for staghorn stones and large kidney stones is percutaneous nephrolithotomy (PCNL). Ultrasound-guided PCNL has definite advantages over fluoroscopy-guided PCNL. Preoperative characteristics are essential to assess better surgical outcomes. The goal of this study was to analyze the correlation of hydronephrosis with surgical outcomes after ultrasound-guided supine PCNL.
A retrospective study was conducted at Doris Sylvanus General Hospital. Data of the patients was obtained from hospital records. Hundred and five patients underwent ultrasound-guided PCNL in the supine position from August 2020 to August 2022. Data were analyzed using SPSS 16.0.
The presence of hydronephrosis was 85 (80.95%), which consisted of Grade I 15 (14.30%), Grade II 25 (23.80%), Grade III 28 (26.70%), and Grade IV 17 (16.20%). In our study analysis, complications occurred in 16 patients (15.23%). Grade I complications of the Clavien-Dindo classification was of in 4 cases, 11 cases of grade 2 complications, and 1 patient died. The statistical result was the relationship between grade hydronephrosis and the grade of complication using the modified Clavien-Dindo system. We found a p-value of 0.207 (>0.05), and there is no statistically significant relationship p=0.382 and r=-0.086 was a negative correlation. There is also no statistically significant relationship between hydronephrosis and stone clearance with p=0.310.
The use of ultrasonographic guidance PCNL has been reported as a safe and effective procedure for the management of large renal stones. In this study, there was no correlation or signification between hydronephrosis and surgical outcome after ultrasound-guided supine PCNL.
鹿角形结石和大肾结石的首选治疗方法是经皮肾镜取石术（PCNL）。超声引导下的PCNL比荧光透视引导下的PCNL具有明显优势。术前特征对于更好地评估手术结果至关重要。本研究的目的是分析肾积水与超声引导下仰卧位PCNL术后手术结果的相关性。
在多丽丝·西尔瓦努斯综合医院进行了一项回顾性研究。患者数据从医院记录中获取。2020年8月至2022年8月，105例患者接受了超声引导下的仰卧位PCNL。使用SPSS 16.0对数据进行分析。
存在肾积水的患者有85例（80.95%），其中I级15例（14.30%），II级25例（23.80%），III级28例（26.70%），IV级17例（16.20%）。在我们的研究分析中，16例患者（15.23%）出现并发症。Clavien-Dindo分类的I级并发症有4例，II级并发症11例，1例患者死亡。统计结果是使用改良的Clavien-Dindo系统分析肾积水分级与并发症分级之间的关系。我们发现p值为0.207（>0.05），无统计学显著关系，p = 0.382且r = -0.086为负相关。肾积水与结石清除率之间也无统计学显著关系，p = 0.310。
超声引导下PCNL已被报道为治疗大型肾结石的一种安全有效的方法。在本研究中，超声引导下仰卧位PCNL术后肾积水与手术结果之间无相关性或显著性。
