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回顾性比较孙氏可屈式半硬性输尿管镜术、超微经皮肾镜取石术和软性输尿管镜术在上尿路结石治疗中的应用。

A retrospective comparison of Sun's tip-flexible semirigid ureterorenoscopy, super-mini percutaneous nephrolithotomy and flexible ureteroscopy applied to treat upper urinary tract calculi.

机构信息

Department of Urology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China.

出版信息

BMC Urol. 2024 Feb 14;24(1):39. doi: 10.1186/s12894-024-01412-z.

Abstract

BACKGROUND

This retrospective study was conducted to compare the safety and efficacy of Sun's tip-flexible semirigid ureterorenoscopy (tf-URS), super-mini percutaneous nephrolithotomy (SMP) and flexible ureteroscopy (FURS) in treating upper urinary tract calculi, including upper ureteral or renal calculi.

METHODS

We included patients with upper ureteral calculi or renal calculi 1.0-2.0 cm in size, who underwent tf-URS, SMP or FURS, respectively. The indicators reflecting safety and efficacy were compared among the three surgical techniques.

RESULTS

SMP presented with higher single stone crushing success rate, but longer operation time and postoperative hospital stay, more blood loss, and higher postoperative pain score compared with FURS and tf-URS (P < 0.05). The hospitalization cost of tf-URS group was lower than that of SMP and FURS groups (P < 0.05). The incidence of postoperative fever in tf-URS group was significantly higher than that in SMP group (P < 0.05). No significant difference was found in mucosal injury, perirenal hematoma, and stone-free rate at 3 months after surgery (P > 0.05).

CONCLUSIONS

tf-URS and FURS have the advantages in minimal invasion, hospitalization cost, patient comfort, and hospital stay while SMP has higher stone-free rate. These three surgical techniques are safe, reliable and complementary, which should be selected according to the actual situation.

摘要

背景

本回顾性研究旨在比较 Sun 的 tip-flexible 半刚性输尿管镜(tf-URS)、超微经皮肾镜取石术(SMP)和软性输尿管镜(FURS)治疗上尿路结石(包括输尿管上段或肾结石)的安全性和疗效。

方法

我们纳入了大小为 1.0-2.0cm 的输尿管上段结石或肾结石患者,分别接受 tf-URS、SMP 或 FURS 治疗。比较了三种手术技术的安全性和疗效指标。

结果

SMP 单次碎石成功率较高,但手术时间和术后住院时间较长,出血量较多,术后疼痛评分较高,与 FURS 和 tf-URS 相比(P<0.05)。tf-URS 组的住院费用低于 SMP 和 FURS 组(P<0.05)。tf-URS 组术后发热发生率明显高于 SMP 组(P<0.05)。术后 3 个月黏膜损伤、肾周血肿和结石清除率无显著差异(P>0.05)。

结论

tf-URS 和 FURS 具有微创、住院费用低、患者舒适度高、住院时间短的优点,而 SMP 具有较高的结石清除率。这三种手术技术均安全、可靠且互为补充,应根据实际情况选择。

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