哪个位置更有利于皮肤穿透性腎石切開:仰卧或俯卧?
Mustafa Kucukyangoz1, Adnan Gucuk2
1Department of Urology, Necip Fazil City Hospital, Kahramanmaraş, Turkey. kucukyangoz42@hotmail.com.
Urolithiasis
|August 14, 2023
概括
通过皮肤结核切除术 (PNL) 的仰卧姿势比俯卧姿势具有优势,包括减少光镜时间和在迷你PNL (mPNL) 期间减少双J支架插入. 这种过渡有助于进行更少的侵入性手术,而不会影响成功率或并发症概况.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 腎石病的管理方法
背景情况:
- 透皮骨切除术 (PNL) 是对结石的标准治疗方法.
- 传统上是在俯卧的位置进行的PNL也可以适应卧卧的位置.
- 评估卧卧姿势的好处对于外科手术技术的进步至关重要.
研究的目的:
- 为了比较卧底穿皮神经脊髓切除术 (PNL) 与倾斜PNL的便利性和优势.
- 评估手术和术后结果,特别是对于小型PNL (mPNL).
- 评估在PNL手术中切换外科定位的可行性.
主要方法:
- 追溯对94名患者进行卧式PNL (组-1) 和93名患者进行倾斜PNL (组-2) 的回顾.
- 专注于迷你PNL (mPNL) 亚组:躺着的77人 (组-1A) 和倾斜的53人 (组-2A).
- 人口统计数据,手术时间,光镜持续时间,双J支架 (DJS) 插入率,成功率和并发症的比较.
主要成果:
- 卧卧的mPNL (74.4分钟) 和倾斜的mPNL (79.2分钟) (p=0.076) 的操作时间是可比的.
- 辅食mPNL显示显著缩短了光镜的中位数时间 (30s vs 40s,p=0.003).
- 类mPNL的插入率明显较低 (23.4%对54.7%,p<0.001),并且mPNL的发生率更高 (81.9%对57%,p<0.001).
结论:
- 在PNL,特别是mPNL的卧卧姿态显示了优势,包括减少光镜时间和更少的DJS插入.
- 卧卧的方法有助于更高地采用最少侵入性的PNL技术.
- 在仰卧和俯卧位置之间没有观察到mPNL成功率或并发症概况的显著差异.
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