Urology Surgery, Kashi Prefecture Second People's Hospital, 844000 Kashgar, Xinjiang, China.
Arch Esp Urol. 2024 May;77(4):418-425. doi: 10.56434/j.arch.esp.urol.20247704.57.
Kidney stones, a common urinary system ailment, often necessitate surgical intervention. Endoscopic combined intrarenal surgery (ECIRS) and multi-channel percutaneous nephron lithotripsy (MPCNL) are key modalities for treating complex renal stones, prompting the need for a comparative analysis to enhance clinical decision-making.
Patients undergoing surgical treatment for complex kidney stones from April 2018 to April 2022 were divided into the control (MPCNL) and observation (ECIRS) groups. Propensity score matching was used to balance baseline data, and -tests and chi-square tests were employed to compare the perioperative indicators between the two groups.
A total of 210 patients were enrolled in this study for pre-observational comparison, and they were divided into the control group (110 patients) and observation group (100 patients). Following matching, each group comprised 85 patients. Pre-observational comparison revealed significant differences between the groups in age, disease duration, and stone diameter ( < 0.05). However, after matching, baseline data comparison showed no statistically significant differences ( > 0.05). Surgery-related parameters, including operation time, intraoperative blood loss, postoperative activity duration and hospital stay, did not significantly differ between the groups ( > 0.05). The observation group exhibited a significantly higher stone retention-free rate after initial treatment compared with the control group ( < 0.05), although overall stone clearance rates did not significantly differ between the groups ( > 0.05). We found no significant differences in perioperative complications between the two groups ( > 0.05). Moreover, the observation group experienced significantly lower postoperative pain levels at 6, 24 and 48 h compared with the control group ( < 0.001).
Conclusively, ECIRS and MPCNL are viable options for treating complex renal calculi, with similar operation times, complication rates and stone clearance rates. ECIRS may offer advantages including lower postoperative pain and higher initial stone clearance rates than MPCNL. However, large-scale studies with long follow-up times are needed for validation.
肾结石是一种常见的泌尿系统疾病，常需手术干预。经皮肾镜碎石取石术（MPCNL）和内镜下联合肾内手术（ECIRS）是治疗复杂性肾结石的主要方法，需要进行对比分析以辅助临床决策。
选择 2018 年 4 月至 2022 年 4 月收治的行手术治疗的复杂性肾结石患者，分为对照组（MPCNL）和观察组（ECIRS）。采用倾向性评分匹配法均衡基线资料，采用 t 检验和卡方检验比较两组围手术期指标。
本研究共纳入 210 例患者进行预观察性比较，分为对照组（110 例）和观察组（100 例）。匹配后，每组各 85 例。预观察性比较显示，两组在年龄、病程和结石直径方面存在显著差异（<0.05）。但匹配后，基线资料比较无统计学差异（>0.05）。手术相关参数，包括手术时间、术中出血量、术后活动时间和住院时间，两组间差异无统计学意义（>0.05）。观察组初始治疗后结石无残留率显著高于对照组（<0.05），但两组结石总清除率无显著差异（>0.05）。两组围手术期并发症发生率无显著差异（>0.05）。观察组术后 6、24、48 h 时的疼痛评分显著低于对照组（<0.001）。
ECIRS 和 MPCNL 均可用于治疗复杂性肾结石，两者手术时间、并发症发生率和结石清除率相似。ECIRS 可能具有术后疼痛轻、初始结石清除率高的优势，但仍需大样本、长期随访的研究加以验证。
