在背部皮肤性瘤切除过程中导航整个收集系统:刚性镜检查足够吗? 一项前性研究由国际结石病联盟的皮皮质神经切除术工作组进行
Mehmet Ilker Gokce1, Giorgio Mazzon2, Dong Nguyen3
1Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
Journal of laparoendoscopic & advanced surgical techniques. Part A
|February 16, 2024
概括
穿皮瘤切除术 (PCNL) 往往需要灵活的镜检查,以获取剩余石块碎片的整个收集系统. 逆向柔性尿管透镜显著提高了PCNL手术中无结石率.
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.
- 腎石病的管理方法
背景情况:
- 通过皮肤结石切除术 (PCNL) 期间,收集系统的完整可视化是必不可少的,以确保没有剩余的石块碎片.
- 传统的刚性镜可能在访问所有腔腔中存在局限性.
研究的目的:
- 在PCNL过程中,使用不同的穿孔位 (下,中,上极) 确定所有形腔的可访问率.
- 评估结合逆行和前级弹性视镜的好处,以改善石头清除.
主要方法:
- 从五个机构中从226名接受卧床PCNL的患者收集前性数据.
- 使用刚性镜检查,前级柔性镜检查和后级柔性尿道镜检查,评估进入所有孔的机会.
- 对前向和后向访问成功率进行比较,以完成收集系统评估.
主要成果:
- 在91.6%的患者中,实现了无石头状态.
- 在50%的病例中,中极穿孔允许在刚性镜中完全访问收集系统,明显高于下极 (37.1%) 或上极 (28.1%) 的穿孔.
- 逆行尿管透镜在访问整个收集系统方面取得了97.6%的成功,远高于逆行方法 (80%).
结论:
- 刚性镜检查单独不足以评估大量PCNL患者的整个采集系统.
- 灵活的镜,特别是通过逆行方法,提高了访问所有收集系统区域的能力,从而提高了无石头率.
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