Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain.
Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain.
Actas Urol Esp (Engl Ed). 2023 Dec;47(10):681-687. doi: 10.1016/j.acuroe.2023.06.004. Epub 2023 Jun 22.
The vacuum-assisted access sheath is a new device for the treatment of kidney stones with percutaneous nephrolithotomy (PCNL).
Our aim was to compare the stone-free rate (SFR) and complications between standard mini percutaneous nephrolithotomy (Mini-PCNL) and vacuum-assisted PCNL (Va-PCNL).
Retrospective study of patients undergoing Mini-PCNL and Va-PCNL from January 2018 to June 2022. Va-PCNL was performed with a disposable sheath (ClearPetra®) with continuous high-flow irrigation and vacuum fluid dynamics for easier stone fragment removal. Baseline patient characteristics, surgical outcomes, perioperative and postoperative data were collected. We compared SFR and complications.
A total of 136 patients were identified, 57 (41,9%) underwent Va-PCNL and 79 (58,15%) Mini-PCNL. Mean operative time was significantly shorter in the Va-PCNL group (95 min.) than in Mini-PCNL (146 min; P = ,001) group. The tubeless technique was performed more frequently in Va-PCNL group (61,4% vs. 34,2%; P = ,002). We did not observe any differences in postoperative complications. The mean hospital stay was significantly lower in Va-PCNL with 1,7 ± 1,9 days per patient compared with 2,7 ± 1,5 days in the Mini-PCNL group (P = ,001). There were no differences in SFR at 3 months between Va-PCNL (71,9%) and Mini-PCNL (71,8%; P =v ,848).
Patients treated with Va-PCNL had comparable results to Mini-PCNL, showing equal SFR with similar infectious complications rates. Potential benefits of Va-PCNL include shorter operative time and postoperative stay.
真空辅助通道鞘是经皮肾镜取石术（PCNL）治疗肾结石的一种新设备。
比较标准微创经皮肾镜取石术（Mini-PCNL）与真空辅助经皮肾镜取石术（Va-PCNL）的无石率（SFR）和并发症。
回顾性分析 2018 年 1 月至 2022 年 6 月期间行 Mini-PCNL 和 Va-PCNL 的患者。Va-PCNL 采用一次性鞘（ClearPetra®）进行，持续高流量冲洗和真空流体动力学，以便更轻松地清除结石碎片。收集基线患者特征、手术结果、围手术期和术后数据。我们比较了 SFR 和并发症。
共纳入 136 例患者，57 例（41.9%）行 Va-PCNL，79 例（58.15%）行 Mini-PCNL。Va-PCNL 组的手术时间明显短于 Mini-PCNL 组（95 分钟 vs. 146 分钟；P ＝0.001）。Va-PCNL 组更常采用无管技术（61.4% vs. 34.2%；P ＝0.002）。两组术后并发症无差异。Va-PCNL 组的平均住院时间明显较低，每位患者为 1.7±1.9 天，而 Mini-PCNL 组为 2.7±1.5 天（P ＝0.001）。3 个月时，Va-PCNL 组的 SFR（71.9%）与 Mini-PCNL 组（71.8%；P ＝0.848）无差异。
Va-PCNL 治疗的患者与 Mini-PCNL 结果相当，具有相似的 SFR 和相似的感染并发症发生率。Va-PCNL 的潜在优势包括手术时间更短和术后住院时间更短。
