Liang Jian, He Jingwei, Lin Hansheng, Feng Nengzhuo, Qin Wenchao, Zhuo Yumin
Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Urology, The Affiliated Yangjiang People's Hospital of Guangdong Medical University, Yangjiang, Guangdong, China.
Urolithiasis. 2025 Jul 24;53(1):143. doi: 10.1007/s00240-025-01807-z.
We conducted a prospective, randomized study to compare the safety and efficacy of using a conventional nephrostomy sheath (CNS) versus a minimally invasive suction-evacuation nephrostomy sheath (SENS) for treating partial staghorn stones. Eighty-six patients with partial staghorn stones were randomly assigned into two groups, with 43 patients in each group. One group underwent standard percutaneous nephrolithotomy (sPCNL) using CNS, whereas the other group underwent minimally invasive percutaneous nephrolithotomy (mPCNL) with SENS. Patient demographics, stone characteristics, intraoperative data, perioperative data, and surgical results were collected and analyzed.The patient demographics and stone characteristics were similar in both groups. The SENS group had significantly lower peak and mean intrarenal pressure (IRP) during the procedure. The stone-free rate (SFR) was comparable between groups. The SENS group removed stones more efficiently, with shorter treatment time and less frequent use of the stone extractor. Lower IRP and shorter treatment time led to fewer postoperative complications.mPCNL with SENS results in lower IRP, faster stone removal, and reduced use of stone forceps while preserving SFR and safety.
我们进行了一项前瞻性随机研究，以比较使用传统肾造瘘鞘（CNS）与微创抽吸排空肾造瘘鞘（SENS）治疗部分鹿角形结石的安全性和有效性。86例部分鹿角形结石患者被随机分为两组，每组43例。一组使用CNS进行标准经皮肾镜取石术（sPCNL），而另一组使用SENS进行微创经皮肾镜取石术（mPCNL）。收集并分析患者人口统计学资料、结石特征、术中数据、围手术期数据和手术结果。两组患者的人口统计学资料和结石特征相似。SENS组在手术过程中的肾内压峰值和平均肾内压（IRP）显著较低。两组的结石清除率（SFR）相当。SENS组结石清除效率更高，治疗时间更短，结石取出器使用频率更低。较低的IRP和较短的治疗时间导致术后并发症更少。使用SENS的mPCNL可降低IRP，更快地清除结石，减少结石钳的使用，同时保持SFR和安全性。
