Department of Urology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
Department of Urology, Changsha Economic Development Zone Hospital, Changsha, Hunan, 410100, China.
Urolithiasis. 2024 Apr 3;52(1):59. doi: 10.1007/s00240-024-01567-2.
To evaluate the safety and efficacy of tubeless percutaneous nephrolithotomy (PCNL) in patients with Escherichia coli (E. coli) bacteriuria. We conducted a retrospective review of 84 patients with E. coli bacteriuria who underwent PCNL. Patients were divided into two groups according to whether a nephrostomy tube is placed at the end of the procedure. Preoperative clinical data, surgical outcomes, and postoperative complications were compared. Then, regression analysis of factors predicting success rate of PCNL in patients with E. coli bacteriuria was performed. After PCNL, residual fragments ≤ 4 mm were considered as success. At baseline, the two groups were similar with regard to age, gender, BMI, underlying disease, hydronephrosis, stone characteristics, and urinalysis. Postoperative fever occurred in 1 patient (3.8%) in the tubeless PCNL group, and in 5 patients (8.6%) in the conventional PCNL group (p > 0.05). There were no significant differences in terms of successful rate, decrease in hemoglobin, pain scores, blood transfusion, and hospitalization expenses. However, the tubeless PCNL group had significantly shorter operative time (60 vs. 70 min, p = 0.033), indwelling time of catheter (2 vs. 4 days, p < 0.001), and hospital stays (3 vs. 5 days, p < 0.001) than the conventional PCNL group. In the analysis of factors predicting success, the stone diameter, stone burden, and operative time were associated with success rate of PCNL. It is safe and effective to perform tubeless PCNL in patients with E. coli bacteriuria. Compared to conventional PCNL, tubeless PCNL accelerates patient recovery and shortens hospital stays.
评估无管经皮肾镜取石术（PCNL）在大肠埃希菌（E. coli）菌尿症患者中的安全性和疗效。我们对 84 例 E. coli 菌尿症患者进行了回顾性分析，这些患者均接受了 PCNL。根据手术结束时是否放置肾造瘘管，将患者分为两组。比较了两组患者的术前临床资料、手术结果和术后并发症。然后，对预测 E. coli 菌尿症患者 PCNL 成功率的因素进行了回归分析。PCNL 后，残余碎片 ≤ 4 mm 被认为是成功的。在基线时，两组患者在年龄、性别、BMI、基础疾病、肾积水、结石特征和尿液分析方面相似。无管 PCNL 组术后发热 1 例（3.8%），常规 PCNL 组 5 例（8.6%）（p > 0.05）。两组患者的成功率、血红蛋白下降、疼痛评分、输血和住院费用无显著差异。然而，无管 PCNL 组的手术时间（60 分钟 vs. 70 分钟，p = 0.033）、导尿管留置时间（2 天 vs. 4 天，p < 0.001）和住院时间（3 天 vs. 5 天，p < 0.001）明显短于常规 PCNL 组。在预测成功率的因素分析中，结石直径、结石负荷和手术时间与 PCNL 的成功率相关。对于 E. coli 菌尿症患者，行无管 PCNL 是安全有效的。与常规 PCNL 相比，无管 PCNL 可加速患者康复，缩短住院时间。
