Department of Urology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
World J Urol. 2024 Jun 13;42(1):376. doi: 10.1007/s00345-024-05076-0.
The purpose of this study was to compare the efficacy and safety of Ultra-mini-percutaneous nephrolithotomy (UMP) and Retrograde intrarenal surgery (RIRS) for renal/upper ureteral calculi in 1.0-2.0 cm diameter.
From October 2017 to October 2022, the surgical treatment of patients with renal/upper ureteral calculi in 1.0-2.0 cm diameter who were admitted to our hospital was retrospectively analyzed. They were divided into two groups, the UMP group (sixty-two cases) and the RIRS group (one hundred and nine cases), according to the different surgical methods. Baseline data includes general information, stone size, location, CT value, hydronephrosis, creatinine level, etc. RESULTS: Intraoperative blood loss was 33.6 ± 8.5 ml in the UMP group was significantly more than 4.3 ± 0.7 ml in the RIRS group (P < 0.05). Intraoperative renal pelvis pressure of UMP group 10.5 ± 1.3 mmHg was significantly lower than RIRS group 23.6 ± 5.6 mmHg (P < 0.05). The incidence of postoperative infection was higher in the RIRS group (thirteen cases [11.93%]), and one case ([1.61%]) in the UMP group (P < 0.05). Routine CT scans on the second day and two months after surgery showed that the stone clearance rates in the UMP group were 87.1% and 93.5%, respectively, higher than those in the RIRS group (69.7% and 79.8%, respectively; P < 0.05).
UMP has the advantage of a higher stone-free rate but a higher risk of injury and bleeding. The advantages of RIRS include less trauma, less bleeding, and faster recovery, but lower stone-free rates and a higher risk of infection.
本研究旨在比较超微经皮肾镜碎石术（UMP）和逆行性肾内手术（RIRS）治疗 1.0-2.0cm 直径肾结石/上段输尿管结石的疗效和安全性。
回顾性分析 2017 年 10 月至 2022 年 10 月我院收治的 1.0-2.0cm 直径肾结石/上段输尿管结石患者的手术治疗资料，根据手术方式的不同分为 UMP 组（62 例）和 RIRS 组（109 例）。收集患者的一般资料、结石大小、位置、CT 值、肾积水程度、血肌酐水平等基线资料。
UMP 组术中出血量为 33.6±8.5ml，明显多于 RIRS 组的 4.3±0.7ml（P<0.05）。UMP 组肾盂内压力为 10.5±1.3mmHg，明显低于 RIRS 组的 23.6±5.6mmHg（P<0.05）。RIRS 组术后感染发生率较高（13 例，11.93%），UMP 组仅 1 例（1.61%）（P<0.05）。术后第 2 天和 2 个月常规 CT 扫描显示，UMP 组结石清除率分别为 87.1%和 93.5%，高于 RIRS 组的 69.7%和 79.8%（P<0.05）。
UMP 结石清除率较高，但损伤和出血风险较高。RIRS 的优点是创伤小、出血少、恢复快，但结石清除率较低，感染风险较高。
