Wei Weiyang, Zhou Chuanpeng, Yang Hao, Wang Qi, Huang Hongxing, Huang Yaqiang
Department of Urology, Zhongshan City People's Hospital, Zhongshan, 528400, China.
Sci Rep. 2025 Apr 27;15(1):14727. doi: 10.1038/s41598-025-99087-5.
To compare the clinical efficacy and safety of mini-percutaneous nephrolithotomy (MPCNL) and standard percutaneous nephrolithotomy (SPCNL) in the treatment of kidney stones combine with renal insufficiency. The data of 320 patients with renal calculi and an eGFR < 60 mL/min/1.73m who underwent percutaneous nephrolithotomy (PCNL) at Zhongshan City People's Hospital from January 2018 to June 2023 were retrospectively analyzed; 164 patients were treated with MPCNL, and 156 were treated with SPCNL. The clinical efficacy of the MPCNL and SPCNL regimens was compared in terms of stone-free rate (SFR), renal function change, hemoglobin (HGB) drop and other complication rates (complications were classified by using the Clavien‒Dindo system). The SFR was 67.1% in the MPCNL group and 67.9% in the SPCNL group (P = 0.867). The overall eGFR of the two groups was significantly improved at 1 month after the operation (P < 0.001). Postoperative renal function was stable, improved and worse in 50.0% (n = 82) vs. 53.8% (n = 84), 39.0% (n = 64) vs. 42.4% (n = 66) and 11.0% (n = 18) vs. 3.8% (n = 6) of the MPCNL and SPCNL patients, respectively, compared with preoperative renal function (P = 0.053). In addition, the overall postoperative complication rates between the two groups was not significantly different (P = 0.103). Patients who underwent MPCNL had a lower transfusion rate (7.9% vs. 16.7%, P = 0.017) and shorter hospital stay (4.57 ± 3.14 vs. 7.16 ± 4.05 days, P < 0.001) than those in the SPCNL group. MPCNL and SPCNL have positive effects on the treatment of renal calculi in patients with renal insufficiency; both have acceptable SFRs and complication rates, stable or improved renal function in most patients.
比较微创经皮肾镜取石术（MPCNL）与标准经皮肾镜取石术（SPCNL）治疗肾结石合并肾功能不全的临床疗效及安全性。回顾性分析2018年1月至2023年6月在中山市人民医院接受经皮肾镜取石术（PCNL）的320例估算肾小球滤过率（eGFR）＜60 mL/min/1.73m²的肾结石患者资料；其中164例行MPCNL治疗，156例行SPCNL治疗。从结石清除率（SFR）、肾功能变化、血红蛋白（HGB）下降情况及其他并发症发生率（并发症采用Clavien-Dindo系统分类）方面比较MPCNL和SPCNL治疗方案的临床疗效。MPCNL组的SFR为67.1%，SPCNL组为67.9%（P = 0.867）。两组术后1个月时总体eGFR均显著改善（P ＜0.001）。与术前肾功能相比，MPCNL组和SPCNL组术后肾功能稳定、改善及恶化的患者分别为50.0%（n = 82）对53.8%（n = 84）、39.0%（n = 64）对42.4%（n = 66）、11.0%（n = 18）对3.8%（n = 6）（P = 0.053）。此外，两组术后总体并发症发生率差异无统计学意义（P = 0.103）。与SPCNL组相比，接受MPCNL治疗的患者输血率更低（7.9%对16.7%，P = 0.017），住院时间更短（4.57 ± 3.14天对7.16 ± 4.05天，P ＜0.001）。MPCNL和SPCNL对肾功能不全患者的肾结石治疗均有积极作用；两者的SFR和并发症发生率均可接受，大多数患者肾功能稳定或改善。
