Cheng Rui-Xiang, Dai Ni, Wang Yan-Min, Qi Pei, Chen Fen
Department of Urology, Wuhan Ninth Hospital, Wuhan 430081, Hubei Province, China.
Department of Urinary Pain, Wuhan Hankou Hospital, Wuhan 430000, Hubei Province, China.
World J Clin Cases. 2024 Mar 6;12(7):1243-1250. doi: 10.12998/wjcc.v12.i7.1243.
It is possible that this condition will lead to urosepsis and progressive deterioration of renal function in the absence of surgical intervention. Several recent clinical studies have shown that multi-tract percutaneous nephrolithotomy (M-PCNL) has a similar stone free rate (SFR) as standard percutaneous nephrolithotomy (S-PCNL). As a result, M-PCNL was also recommended as a treatment option for staghorn calculi.
To examine the perioperative and long-term results of ultrasonography-guided single- and M-PCNL.
This was a retrospective cohort study. Between March 2021 and January 2022, the urology department of our hospital selected patients for the treatment of staghorn calculi using percutaneous nephrolithotomy. The primary outcomes were complication rate and SFR, and the characteristics of patients, operative parameters, laboratory measurements were also collected.
In total, 345 patients were enrolled in the study (186 in the S-PCNL group and 159 in the M-PCNL group). The SFR in the M-PCNL group was significantly higher than that in the S-PCNL group ( = 0.033). Moreover, the incidence rates of hydrothorax ( = 0.03) and postoperative infection ( = 0.012) were higher in the M-PCNL group than in the S-PCNL group. Logistic regression analysis demonstrated that post-operative white blood cell count (OR = 2.57, 95%CI: 1.90-3.47, < 0.001) and stone size (OR = 1.59, 95%CI: 1.27-2.00, < 0.001) were associated with a higher overall complication rate in the S-PCNL group. Body mass index (OR = 1.22, 95%CI: 1.06-1.40, = 0.004) and stone size (OR = 1.70, 95%CI: 1.35-2.15, < 0.001) were associated with increased overall complications in the M-PCNL group.
Multiple access tracts can facilitate higher SFR while slightly increasing the incidence of acceptable complications.
在没有手术干预的情况下，这种情况可能会导致尿脓毒症和肾功能的进行性恶化。最近的几项临床研究表明，多通道经皮肾镜取石术（M-PCNL）与标准经皮肾镜取石术（S-PCNL）的结石清除率（SFR）相似。因此，M-PCNL也被推荐作为鹿角形结石的一种治疗选择。
探讨超声引导下单通道和多通道经皮肾镜取石术的围手术期及长期结果。
这是一项回顾性队列研究。2021年3月至2022年1月期间，我院泌尿外科选择采用经皮肾镜取石术治疗鹿角形结石的患者。主要结局指标为并发症发生率和结石清除率，同时收集患者特征、手术参数、实验室测量数据。
本研究共纳入345例患者（S-PCNL组186例，M-PCNL组159例）。M-PCNL组的结石清除率显著高于S-PCNL组（P = 0.033）。此外，M-PCNL组的胸腔积液发生率（P = 0.03）和术后感染发生率（P = 0.012）高于S-PCNL组。Logistic回归分析表明，S-PCNL组术后白细胞计数（OR = 2.57，95%CI：1.90 - 3.47，P < 0.001）和结石大小（OR = 1.59，95%CI：1.27 - 2.00，P < 0.001）与总体并发症发生率较高有关。在M-PCNL组中体重指数（OR = 1.22，95%CI：1.06 - 1.40，P = 0.004）和结石大小（OR = 1.70，95%CI：1.35 - 2.15，P < 0.001）与总体并发症增加有关。
多通道可提高结石清除率，同时轻微增加可接受并发症的发生率。
