迷你透皮腎石切除術:神經性膀患者的腎石較小是否更好?
C Bouteille1, M Pere2, I Chelghaf3
1Department of Urology, Nantes University Hospital, Nantes, France; 1, place Alexis-Ricordeau, 44000 Nantes, France.
The French journal of urology
|September 27, 2023
概括
在神经性膀患者中,迷你穿皮瘤切除术 (mPCNL) 的疗效与标准PCNL和灵活尿路透镜治疗结石的疗效相当. 然而,与标准PCNL相比,mPCNL的并发症率要低得多.
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) 是一種醫學專業.
- 最少侵入性的手术
背景情况:
- 患有神经性下尿路功能障碍 (NLUTD) 的患者面临尿病的风险增加.
- 在这个人群中,对于结石的迷你穿皮瘤切除术 (mPCNL) 存在有限的数据.
研究的目的:
- 为了比较mPCNL,标准PCNL (sPCNL) 和灵活尿路透镜 (fURL) 的疗效和安全性,用于治疗NLUTD患者的结石.
- 评估一次性无石头率,并发症率,手术时间,血液损失和住院时间.
主要方法:
- 追溯单心研究,包括NLUTD患者和显著的结石.
- 分析的程序:mPCNL (15F),sPCNL (24F) 和fURL.
- 主要终点:CT扫描后3个月的一次性无结石率. 二级终点:克拉维恩-丁多并发症,手术时间,血液损失和住院.
主要成果:
- 在mPCNL (37.5%),sPCNL (38.2%) 和fURL (37%) 中,单次无石头率相似.
- 与sPCNL相比,mPCNL表现出较低的早期并发症,血液损失和输血率,其率与fURL相似.
- 在二次干预后的最终无石头率为mPCNL的48%,sPCNL的61.8%,fURL的63%.
结论:
- 迷你透皮瘤切除术 (mPCNL) 是神经性下尿路功能障碍 (NLUTD) 患者结石的有效治疗方法.
- mPCNL的疗效与标准PCNL和柔性尿路透镜相提并论.
- 在这组患者中,mPCNL的并发症概况明显低于标准PCNL.
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