[迷你PCNL,微PCNL或RIRS:在2厘米以下的结石中比较有效性和安全性]
N I Sorokin1,2,3,4,5, E V Afanasievskaya1,2,3,4,5, A M Kadysheva1,2,3,4,5
1Medical Scientific and Educational Center of Moscow State University by Lomonosov, Moscow, Russia.
Urologiia (Moscow, Russia : 1999)
|October 18, 2023
概括
逆行性内手术 (RIRS) 提供了最高的无结石率,对于长达2厘米的结石. 迷你穿皮瘤切除术 (PCNL) 和微型PCNL显示了类似的结果,而RIRS在并发症和恢复方面显示了优势.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 内分泌病学 在内分泌病学.
- 最少侵入性的手术
背景情况:
- 内镜仪器的小型化是尿病治疗的一个关键趋势.
- 通过皮肤进行的瘤切除术 (PCNL) 和逆行性内外科手术 (RIRS) 代表了微创手术的进步.
- 对这些技术的有效性和安全性的比较研究是有限的.
研究的目的:
- 为了比较迷你PCNL,微PCNL和RIRS的有效性和安全性.
- 为了评估2厘米大小的结石的治疗结果.
主要方法:
- 一项涉及72名接受RIRS (n=30),迷你PCNL (n=26) 或微PCNL (n=16) 的患者的比较研究.
- 程序使用了纤维激光技术.
- 通过CT扫描 (残留碎片> 4毫米) 评估的无结石率 (SFR),并使用Clavien-Dindo分类对并发症进行分级.
主要成果:
- 与迷你PCNL (80.8%) 和微型PCNL (62.5%) 相比,RIRS获得了最高的SFR (93.3%).
- 微型PCNL与RIRS相比,对重复手术 (p=0.026) 和I-II级并发症 (p=0.021) 的需求明显更高.
- RIRS显示了更短的操作时间和更短的住院时间.
结论:
- 在实现无石头状态方面,RIRS优越,并且在并发症,手术持续时间和住院时间方面具有优势.
- 迷你PCNL和微型PCNL显示了可比的疗效和安全性.
- 需要进一步的研究,以建立内镜石管理的最佳治疗算法.
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