经皮肾镜取石术与软性输尿管肾镜术治疗1至2厘米单发性上段输尿管结石的比较：一项回顾性研究

Comparison of percutaneous nephrolithotomy and flexible ureterorenoscopy in the treatment of single upper ureteral calculi measuring 1 to 2 centimeters: a retrospective study.

作者信息

He Qinghua, Wei Xuedong, Wu Eran, Luo Raoshan, Yu Lizhi, Liang Weiming

机构信息

The First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, 124 Yuejin Road, Liuzhou, 545000, Guangxi Province, China.

出版信息

BMC Urol. 2024 Jan 28;24(1):23. doi: 10.1186/s12894-024-01408-9.

DOI:10.1186/s12894-024-01408-9

PMID:38281932

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10822141/

Abstract

PURPOSE

To compare the efficacy and safety of micropercutaneous nephrolithotomy (MPCNL) and flexible ureteroscopy (FURS) in the treatment of single upper ureteral calculi measuring 1 to 2 centimeters.

METHODS

This study is a retrospective analysis that combines a review of medical records with an outcomes management database. A total of 163 patients who underwent MPCNL and 137 patients who had FURS were identified between January 2017 and December 2021. Demographic data, operation time, hospitalization time, stone-free rate, and complication rate were collected and analyzed.

RESULTS

Preoperative general data of sex, age, BMI, serum creatinine, time of stone existence, stone hardness, stone diameter, preoperative hydronephrosis, and preoperative infection of the MPCNL group have no statistically significant difference with that of the FURS group. All MPCNL or FURS operations in both groups were successfully completed without any instances of reoperation or conversion to another surgical procedure. Patients who underwent MPCNL had a considerably reduced operation time (49.6 vs. 72.4 min; P<0.001), but a higher duration of hospitalization (9.1 vs. 3.9 days; P<0.001) compared to those who underwent FURS. The stone-free rate in the MPCNL group was superior to that of the FURS group, with a percentage of 90.8% compared to 71.5% (P<0.001). There was no statistically significant disparity in the rate of complications between the two groups (13.5% vs. 15.3%; P = 0.741).

CONCLUSION

Both MPCNL and FURS are viable and secure surgical choices for individuals with solitary upper ureteral calculi measuring 1 to 2 cm. The FURS procedure resulted in a shorter duration of hospitalization compared to MPCNL. However, it had a comparatively lower rate of successfully removing the stones and required a longer duration for the operation.There were no substantial disparities observed in the complication rate between the two groups.FURS is the preferable option for treating uncomplicated upper ureteral calculi, whereas MPCNL is the preferable option for treating complicated upper ureteral calculi.Prior to making treatment options, it is crucial to take into account the expertise of surgeons, the quality of the equipment, and the preferences of the patient.

TRIAL REGISTRATION

No.

摘要

目的

比较微通道经皮肾镜取石术（MPCNL）和输尿管软镜碎石术（FURS）治疗直径1至2厘米的单一上段输尿管结石的疗效和安全性。

方法

本研究是一项回顾性分析，将病历审查与结果管理数据库相结合。在2017年1月至2021年12月期间，共确定了163例行MPCNL的患者和137例行FURS的患者。收集并分析人口统计学数据、手术时间、住院时间、结石清除率和并发症发生率。

结果

MPCNL组术前的性别、年龄、体重指数、血清肌酐、结石存在时间、结石硬度、结石直径、术前肾积水和术前感染等一般数据与FURS组相比，差异无统计学意义。两组所有的MPCNL或FURS手术均成功完成，无再次手术或转为其他手术的情况。与接受FURS的患者相比，接受MPCNL的患者手术时间明显缩短（49.6对72.4分钟；P<0.001），但住院时间更长（9.1对3.9天；P<0.001）。MPCNL组的结石清除率优于FURS组，分别为90.8%和71.5%（P<0.001）。两组并发症发生率差异无统计学意义（13.5%对15.3%；P = 0.741）。

结论

MPCNL和FURS对于直径1至2厘米的单一上段输尿管结石患者都是可行且安全的手术选择。与MPCNL相比，FURS手术住院时间较短。然而，其结石清除成功率相对较低，手术时间较长。两组并发症发生率无显著差异。FURS是治疗单纯上段输尿管结石的首选，而MPCNL是治疗复杂上段输尿管结石的首选。在做出治疗选择之前，考虑外科医生的专业技能、设备质量和患者的偏好至关重要。