逆行性内外科手術の複数のセッションで結石のない状態を達成するための予測要因
Volkan Selmi1, Mehmet Caniklioglu1, Sercan Sari1
1Department of Urology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkiye.
まとめ
腎臓石の治療には複数の逆行性腎内外科手術 (RIRS) の必要性を予測する. これらの要因のない患者は,RIRSの手順の後に石のない状態を達成する可能性が高い.
科学分野:
- 泌尿器科
- 腎臓科
- 外科 革新
背景:
- 腎臓石は人口のかなりの部分に影響します
- 逆行性腎内手術 (Retrograde intrarenal surgery,RIRS) は,腎石に対する最小侵襲的治療法である.
- RIRSの後に石のない状態を達成することは,重要な成果の指標です.
研究 の 目的:
- 石のない状態を達成するために複数のRIRSセッションを必要とする予測要因を特定する.
- 患者と石の特徴を区別するために,単一の対複数のRIRS介入.
- RIRSの患者の選択と治療計画を改善する.
主な方法:
- 腎石に対するRIRSを受けた487人の患者を対象とした記述的研究.
- 患者は2つのグループに分けられた: 1回のRIRSセッション (グループI) と複数のRIRSセッション (グループII).
- 多数のRIRSセッションの予測要因を特定するために,ロジスティック回帰分析が使用されました.
主要な成果:
- 石の位置,水解症の存在,および石の量が高いことが,複数のRIRSセッションを必要とする重要な予測因子であった (p = 0.042,p = 0.018,p = 0.040).
- 患者の人口統計 (性別,年齢) や他の石の特徴 (密度,数,サイズ,横方向性,手術時間) は予測的ではありませんでした.
- これらの発見は,複数のセッションでの治療の必要性に関する特定の指標を強調しています.
結論:
- 下部に結石がある患者,水解症,大きな結石の患者では,1回のRIRSセッションで結石のない状態を達成する確率は低い.
- 対照的に,これらの指標のない患者は,RIRSの手順の後に成功する確率が高い.
- これらの要因は,効果的な腎結石病管理のために必要なRIRSセッションの予想される数に関する臨床的決定を導くことができます.
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