对于2-3厘米的结石而言,真空辅助的微型皮肤透膜腎石切除术:与逆行性内手术进行比较研究
Giuseppe Collura1, Giulia D'Ippolito2, Ana Ludy Lopes Mandes1
1Paediatric Urology Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy.
Journal of pediatric surgery
|November 16, 2023
概括
与儿童的逆行性内手术 (RIRS) 相比,真空辅助皮肤瘤切除术 (VAmini-PCNL) 提供更高的无结石率和更短的手术时间. 这项研究强调VAmini-PCNL作为治疗大型结石的安全有效选择.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 最少侵入性的手术
- 腎石病的治療方法
背景情况:
- 儿童结石会带来严重的治疗挑战.
- 穿皮瘤切除术 (PCNL) 和逆行性内手术 (RIRS) 是常见的治疗方式.
- 真空辅助迷你PCNL (VAmini-PCNL) 是一种较新的技术,需要进一步进行比较评估.
研究的目的:
- 为了比较VAmini-PCNL与RIRS对儿科结石 (2-3厘米) 的疗效和安全性.
- 评估关键的终点,包括操作时间,无石头率 (SFR) 和并发症率.
主要方法:
- 15名接受VAmini-PCNL (2020年后) 治疗的儿童与15名接受RIRS治疗的匹配儿童的回顾性比较.
- VAmini-PCNL使用了一个12-Ch镜和16-Ch接入.
- RIRS使用了灵活的尿管镜,并考虑了前支架.
主要成果:
- 群体之间的年龄,石块大小或密度没有显著差异.
- VAmini-PCNL的操作时间显著缩短 (85.3分 vs. 150.6分,p=0.00001).
- 与RIRS相比,VAmini-PCNL实现了100%的SFR (p=0.02),而RIRS需要40%的情况进行二次程序.
结论:
- 对于患有结石的1岁以上儿童,VAmini-PCNL是一种可行且安全的选择.
- 与RIRS相比,VAmini-PCNL提供更优质的SFR和更短的操作时间.
- 在这个群体中,RIRS在33%的病例中需要预先切口,而在40%的病例中需要二次手术.
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