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尼日利亚一家三级医院上尿路结石的特征及逆行肾内手术联合激光碎石术的治疗结果:一项回顾性研究

Upper urinary tract stone characteristics and outcome of retrograde intra renal surgery with laser lithotripsy in a Nigerian tertiary hospital: a retrospective study.

作者信息

Ozah Ehiremhen, Okonji Nkemdilim Ifeyinwa Oyetola

机构信息

Department of Surgery, University of Benin Teaching Hospital, Benin-City, Edo State, Nigeria.

出版信息

Niger Med J. 2024 Nov 6;65(5):604-620. doi: 10.60787/nmj-v65i3.475. eCollection 2024 Sep-Oct.

Abstract

BACKGROUND

This study is therefore aimed at assessing upper urinary tract stone characteristics, the outcome of retrograde intrarenal surgery with laser lithotripsy, and factors predicting stone-free status.

METHODOLOGY

This was a retrospective cross-sectional study carried out on all patients who had retrograde intra-renal surgery with laser lithotripsy for upper urinary tract stones from 2021-2023 at the Urology unit, department of Surgery, University of Benin Teaching Hospital. Electronic medical records were retrieved with data on demographics, serum calcium level, and non-contrast computed tomography scans assessing stone size, location, laterality, multiplicity, density, and renal anatomy.

RESULTS

The data Thirty- three patients were extracted and analysed with a mean age of 43,70+/- 11.44 years, 54.5% of patients were male. The mean duration of admission was 2.4+/-1.5 days. The mean body mass Index was 26.84+/- 4.37 kg/m2. All patients had flank pains; 7(41.2%) patients had bilateral renal stones. The majority of renal stones 8(47.1%) were located in the lower pole of the kidney. A greater proportion of calculus was ureteric 23(69.7%), mean stone size was 13.2+/- 15.2mm, while mean stone density was 817+/- 285.5 HU. Fifteen participants (45.5%) had multiple stones. Stone clearance assessed on imaging was 75.8%. Age, sex, stone size, density and location, and multiplicity of stones were statistically significant determinants of stone clearance (p= 0210, 1.000, 0.220, 0.380. 0.366 and 1.000) respectively, similarly, no statistically significant predictors of stone clearance were found in this study.

CONCLUSION

The study revealed a predominance of upper urinary tract stones in males, with most patients being overweight. There was a weak correlation between stone density and serum calcium level in this study. Findings in this study revealed no statistically significant determinant or predictors of stone clearance.

摘要

背景

因此,本研究旨在评估上尿路结石特征、激光碎石逆行肾内手术的结果以及预测结石清除状态的因素。

方法

这是一项回顾性横断面研究,对2021年至2023年在贝宁大学教学医院外科泌尿外科接受上尿路结石激光碎石逆行肾内手术的所有患者进行。检索电子病历,获取有关人口统计学、血清钙水平以及评估结石大小、位置、侧别、多发性、密度和肾脏解剖结构的非增强计算机断层扫描的数据。

结果

提取并分析了33例患者的数据,平均年龄为43.70±11.44岁,54.5%的患者为男性。平均住院时间为2.4±1.5天。平均体重指数为26.84±4.37kg/m²。所有患者均有胁腹痛;7例(41.2%)患者有双侧肾结石。大多数肾结石8例(47.1%)位于肾下极。输尿管结石占比更大,为23例(69.7%),平均结石大小为13.2±15.2mm,而平均结石密度为817±285.5HU。15名参与者(45.5%)有多发结石。影像学评估的结石清除率为75.8%。年龄、性别、结石大小、密度和位置以及结石的多发性分别是结石清除的统计学显著决定因素(p分别为0.210、1.000、0.220、0.380、0.366和1.000),同样,本研究未发现结石清除的统计学显著预测因素。

结论

该研究显示男性上尿路结石占主导,大多数患者超重。本研究中结石密度与血清钙水平之间存在弱相关性。本研究结果显示没有结石清除的统计学显著决定因素或预测因素。

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Retrograde intrarenal surgery for renal stones - Part 1.肾结石的逆行肾内手术 - 第1部分。
Turk J Urol. 2017 Jun;43(2):112-121. doi: 10.5152/tud.2017.03708. Epub 2017 Jun 1.

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