在肥胖患者中进行迷你和标准的皮肤穿透性利切除术. 来自单个外科医生大型系列的结果
Angelo Cormio1, Mario Auciello2, Ugo Giovanni Falagario2
1Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, School of Urology, Faculty of Medicine, Università Politecnica delle Marche, Ancona, Italy.
European urology open science
|April 9, 2024
概括
与肥胖患者的标准PCNL相比,微型皮肤穿神经切除术 (PCNL) 提供了更好的无石头率和更少的输血需求. 迷你和标准PCNL都是接受结石治疗的肥胖个体的安全选择.
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.
- 手术创新 在外科创新.
背景情况:
- 穿皮骨切除术 (PCNL) 是大型或复杂的结石的标准治疗方法.
- 肥胖症在治疗结石方面存在独特的挑战,可能会影响治疗的有效性和安全性.
研究的目的:
- 为了评估肥胖患者与非肥胖患者的迷你PCNL结果.
- 为了比较迷你PCNL与标准PCNL,特别是在肥胖患者群体内.
主要方法:
- 一个PCNL数据库 (2005-2022) 的回顾性分析.
- 微型 (17.5Ch) 和标准 (≥26Ch) PCNL之间的结果 (手术时间,无结石率,并发症) 的比较.
- 多变量后勤回归以确定影响无石头率和并发症的因素.
主要成果:
- 迷你和标准PCNL在非肥胖和肥胖患者中显示了相似的结果,涉及手术时间,术后停留时间和并发症率.
- 在肥胖患者中,迷你PCNL与标准PCNL相比,显著缩短了手术时间 (60分钟 vs 94分钟),更高的无石头率 (85% vs 63.8%),以及更低的输血率 (2% vs 10%).
- 多变量分析证实,微型PCNL与没有石头的可能性更高 (OR 1.79) 和需要输血的可能性更低 (OR 0.28).
结论:
- 迷你和标准PCNL对于患有结石的肥胖患者都是安全有效的.
- 与肥胖人口中的标准PCNL相比,迷你PCNL在石头清理和减少输血需求方面提供了更好的结果.
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