Perri Davide, Besana Umberto, Maltagliati Matteo, Pacchetti Andrea, Calcagnile Tommaso, Pastore Antonio Luigi, Romero-Otero Javier, Micali Salvatore, Govorov Alexander, Somani Bhaskar, Liatsikos Evangelos, Knoll Thomas, Rocco Bernardo, Bozzini Giorgio
Department of Urology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy.
Division of Urology, Sant'Anna Hospital, Via Ravona 20, 22042, San Fermo della Battaglia, Italy.
World J Urol. 2025 Jan 20;43(1):79. doi: 10.1007/s00345-025-05445-3.
To assess differences in safety and efficacy between 24 and 18 Fr pneumatic balloon dilators for percutaneous nephrolithotripsy (PCNL) of renal stones between 10 and 20 mm.
Patients were randomized to dilatation with a 24 Fr (Group A) versus 18 Fr (Group B) Ultraxx pneumatic dilator (Cook Medical). In all procedures percutaneous puncture was performed under ultrasound guidance. In both groups the Holmium: YAG Cyber Ho laser generator was used (Quanta System). Stone-free rate (SFR) and postoperative complications were assessed.
42 and 44 patients were assigned to Groups A and B, respectively. Preoperative features were comparable. Mean stone size was 17.8 vs. 16.6 mm in Group A vs. B (p = 0.21). SFR was 95.2% in Group A and 95.4% in Group B (p = 0.19). Postoperative gross haematuria was observed in 5 vs. 2 cases in Group A vs. B (p = 0.04). Mean haemoglobin drop at first postoperative day (POD) was higher in Group A (2.4 vs. 1.1 mg/dl, p = 0.04), while comparable at third POD. Blood transfusion was required in 2 cases in Group A and 1 case in Group B. No patients required embolization. No significant difference was observed in terms of postoperative pain and urinary infection.
24 and 18 Fr pneumatic dilators are both effective to access renal cavity during PCNL for the treatment of renal stones between 10 and 20 mm. Gross haematuria rate and mean haemoglobin decrease at first POD were significantly higher with 24 Fr dilator, but with no differences in the need for blood transfusions and renal embolization.
评估用于经皮肾镜取石术（PCNL）治疗10至20毫米肾结石的24F和18F气动球囊扩张器在安全性和有效性方面的差异。
将患者随机分为使用24F（A组）与18F（B组）Ultraxx气动扩张器（库克医疗公司）进行扩张。在所有手术中，经皮穿刺均在超声引导下进行。两组均使用钬：钇铝石榴石Cyber Ho激光发生器（匡塔系统）。评估结石清除率（SFR）和术后并发症。
分别有42例和44例患者被分配到A组和B组。术前特征具有可比性。A组和B组的平均结石大小分别为17.8毫米和16.6毫米（p = 0.21）。A组的结石清除率为95.2%，B组为95.4%（p = 0.19）。A组和B组分别有5例和2例出现术后肉眼血尿（p = 0.04）。术后第一天（POD）A组的平均血红蛋白下降幅度更高（2.4对1.1毫克/分升，p = 0.04），而在术后第三天POD时两组相当。A组有2例患者需要输血，B组有1例。没有患者需要栓塞治疗。在术后疼痛和泌尿系统感染方面未观察到显著差异。
24F和18F气动扩张器在PCNL治疗10至20毫米肾结石时进入肾腔均有效。24F扩张器的肉眼血尿发生率和术后第一天POD时的平均血红蛋白下降幅度显著更高，但在输血需求和肾栓塞方面无差异。
