无管切除术与标准皮肤穿切除术的并发症
Hayden Hill1, Susan Talamini2, Joel Vetter2
1Department of Surgery, Division of Urology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA. Hillh@wustl.edu.
International urology and nephrology
|September 5, 2023
概括
无管穿皮瘤切除术 (PCNL) 提供更高的无石头率和更短的恢复时间,但可能会增加输血需求. 整体并发症率与标准PCNL相似,这表明外科医生的自由裁量权是关键.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學.
- 外科手术的结果
背景情况:
- 穿皮骨切除术 (PCNL) 是对结石的主要治疗方法.
- 在最近的文献中,PCNL后瘤管的必要性是有争议的.
- 评估无管与标准PCNL的对比对于优化患者护理至关重要.
研究的目的:
- 为了比较无管和标准PCNL之间的术后并发症和结果.
- 分析nephrostomy管放置对PCNL患者康复的影响.
- 为有关PCNL技术的临床决策提供数据驱动的见解.
主要方法:
- 一个机构石头数据库的回顾性审查 (2016年1月 - 2021年12月).
- 329名无管PCNL患者 (仅内泌尿管支架) 与109名标准PCNL患者 (外部化瘤管) 的比较.
- 从分析中排除完全无管的PCNL病例.
主要成果:
- 两组之间再接收率 (6.1%与9.2%) 或Clavien并发症 (≥2或≥3) 没有显著差异.
- 无管PCNL显示较短的操作时间 (121.5分 vs. 144.8分) 和停留时间 (2.5天 vs. 3.8天).
- 在无管组中观察到更高的无石头率 (72.3%对比60.2%),同时增加了输血率 (6.4%对比0.9%).
结论:
- 与标准PCNL相比,无管PCNL不会增加整体并发症率.
- 无管PCNL与改善石头清除和更快的恢复有关.
- 术后输血增加是无管PCNL的考虑因素,但整体结果相似,支持外科医生指导的决策.
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