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仰卧位与俯卧位经皮肾镜取石术治疗小儿肾结石的比较:前瞻性随机研究。

Comparison of supine-prone percutaneous nephrolithotomy methods in the treatment of kidney stones in pediatric patients: prospective randomized study.

机构信息

Yuzuncu Yil University Faculty of Medicine, Van, Turkey.

Siirt Education and Training Hospital, Siirt, Turkey.

出版信息

Urolithiasis. 2024 May 2;52(1):73. doi: 10.1007/s00240-024-01543-w.

Abstract

Mini-PCNL is one of the most effective surgical methods in the treatment of kidney stones in pediatric patients. In this study, we aimed to compare PCNL in the supine-prone position in pediatric patients (especially operation time, postop complications, hospital stay and stone-free rates).We conducted our study in a randomized and prospective manner. Patients with lower pole stones larger than 1 cm, stones larger than 1.5 cm in the pelvis, upper pole, midpole or multiple locations, and patients who did not respond to ESWL or whose family that preferred mini-PCNL to be the primary treatment were included in the study. Patients with any previous kidney stone surgery, patients with coagulation disorders and patients with retrorenal colon were excluded from the study. Between 2021 and 2023, a total of 144 patients underwent PCNL. 68 of these patients had supine PCNL and 76 prone PCNL. Postoperative Clavien grade1 complication occurred in a total of 7 patients in the prone position; Clavien grade1 complication occurred in 1 patient in the supine position. The mean operation time for prone PCNL was 119.88 ± 28.32 min, and the mean operative time for supine PCNL was 98.12 ± 14.97 the mean hospitalization time in prone PCNL was 3.56 ± 1.12 days, and 3.00 ± 0.85 days in supine PCNL. In conclusion, supine PCNL is a safe and effective method in the treatment of pediatric kidney stones and postoperative complications were observed to be less; the operation time and hospital stay were shorter in supine PCNL.

摘要

微创经皮肾镜取石术(mini-PCNL)是治疗小儿肾结石患者的最有效手术方法之一。本研究旨在比较俯卧位和仰卧位 PCNL 在小儿肾结石患者中的应用(尤其是手术时间、术后并发症、住院时间和结石清除率)。我们采用随机前瞻性研究方法。纳入标准为:下盏结石大于 1cm、肾盂内结石大于 1.5cm、肾盂上盏、中盏或多部位结石、对体外冲击波碎石(ESWL)无反应或其家属首选 mini-PCNL 作为主要治疗方法的患者。排除标准为:既往有肾结石手术史、凝血功能障碍和肾后位结肠的患者。2021 年至 2023 年,共有 144 例患者接受了 PCNL。其中 68 例患者接受了仰卧位 PCNL,76 例患者接受了俯卧位 PCNL。俯卧位患者共发生术后 Clavien 1 级并发症 7 例,仰卧位患者发生术后 Clavien 1 级并发症 1 例。俯卧位 PCNL 的平均手术时间为 119.88±28.32min,仰卧位 PCNL 的平均手术时间为 98.12±14.97min,俯卧位 PCNL 的平均住院时间为 3.56±1.12d,仰卧位 PCNL 的平均住院时间为 3.00±0.85d。总之,仰卧位 PCNL 是治疗小儿肾结石的一种安全有效的方法,术后并发症较少,手术时间和住院时间较短。

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本文引用的文献

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