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微创经皮肾镜取石术和逆行性肾内手术治疗下极肾结石的结石清除率和并发症发生率:一项随机试验。

Stone clearance and complication rate of micro percutaneous nephrolithotomy and retrograde intrarenal surgery for lower pole renal stone: A randomized trial.

机构信息

Department of Urology, Lahore General Hospital, Lahore, Pakistan.

Recep Tayyip Erdogan Hospital, Muzaffargarh, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2023 Oct-Dec;35(Suppl 1)(4):S721-S725. doi: 10.55519/JAMC-S4-11807.

DOI:10.55519/JAMC-S4-11807
PMID:38406900
Abstract

BACKGROUND

The use of unhealthy food and a sedentary lifestyle increases daily health problems. Renal stones are one among others. Endourology promises the minimum complications and the highest stone clearance rate. Indications of the two procedures overlap micro-PCNL and RIRS. The objective was to evaluate stone clearance and complication rate of micro-PCNL and RIRS for lower pole renal stones.

METHODS

The research design of this study was a randomized trial and was done after approval of the ethical review committee. The sampling technique was consecutive sampling at the Urology department. Patients included in the study according to inclusion criteria were 96 in number. Randomization into two groups (RIRS vs micro-PCNL) was done by even odd method. All the procedure was done by a single senior urologist.

RESULTS

Their ratio among males and females was 2:1. Mean LOS in the RIRS group was 2.89±0.86 days and in the micro-PCNL group 2.58±0.65 days (p=0.047). The complication rate in the RIRS group was 6.2% and 8.3% in micro-PCNL (p=0.695). Mean post-operative haemoglobin was 12.30±1.07 g/dL among the RIRS group and among the micro-PCNL group it was 11.21±1.08 g/dL (p<0.001). There was an average haemoglobin drop in the micro-PCNL group of 1.09±0.01 g/dL. 75% clearance of stone after one session was achieved in the RIRS group while 79.2% was achieved in the micro-PCNL group (p=0.627).

CONCLUSION

Length of hospital stay (LOS) and stone clearance rate (SFR) were similar in both groups with insignificant statistical differences. There is a need to conduct more studies with a large number of study participants and involving multi-centers.

摘要

背景

不健康的饮食和久坐不动的生活方式会增加日常健康问题。肾结石就是其中之一。腔内泌尿外科治疗具有最小的并发症和最高的结石清除率。微经皮肾镜取石术和输尿管软镜碎石术的适应证有重叠。目的是评估微经皮肾镜取石术和输尿管软镜碎石术治疗下极肾结石的结石清除率和并发症发生率。

方法

本研究的研究设计为随机试验,在伦理审查委员会批准后进行。采用连续抽样的方法,在泌尿外科进行抽样。根据纳入标准,共有 96 名患者被纳入研究。通过奇偶分组法将患者随机分为两组(输尿管软镜碎石术组和微经皮肾镜取石术组)。所有手术均由一位资深泌尿科医生完成。

结果

男女比例为 2:1。输尿管软镜碎石术组的平均住院时间为 2.89±0.86 天,微经皮肾镜取石术组为 2.58±0.65 天(p=0.047)。输尿管软镜碎石术组的并发症发生率为 6.2%,微经皮肾镜取石术组为 8.3%(p=0.695)。输尿管软镜碎石术组术后平均血红蛋白为 12.30±1.07 g/dL,微经皮肾镜取石术组为 11.21±1.08 g/dL(p<0.001)。微经皮肾镜取石术组的血红蛋白平均下降 1.09±0.01 g/dL。输尿管软镜碎石术组有 75%的患者在一次治疗后结石清除,微经皮肾镜取石术组有 79.2%的患者结石清除(p=0.627)。

结论

两组的住院时间(LOS)和结石清除率(SFR)相似,无统计学差异。需要进行更多的研究,纳入更多的研究参与者,并涉及多中心。

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