在肥胖患者中比较卧底和倾斜的迷你皮肤穿透性腎石切除术:一项回顾性研究
Mucahit Gelmis1, Ufuk Caglar1, Abdullah Esmeray1
1Urology, Haseki Training and Research Hospital, Istanbul, Turkey.
Aktuelle Urologie
|September 12, 2024
概括
卧式迷你穿皮瘤切除术 (mPCNL) 对肥胖患者是有效的,与卧卧姿相比,提供更短的操作时间和更少的重大并发症. 建议对那些石头较大或并发症得分较高的人进行仔细监测.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 脊髓石切除术 (nephrolithotomy) 是一个切除术.
背景情况:
- 肥胖症对治疗结石具有独特的挑战.
- 迷你透皮瘤切除术 (mPCNL) 是对结石的关键干预措施.
研究的目的:
- 在肥胖患者中比较卧姿与卧姿mPCNL的安全性和有效性.
- 确定接受mPCNL的肥胖患者并发症的危险因素.
主要方法:
- 对338名肥胖患者 (BMI ≥30) 进行卧卧或倾斜的mPCNL的回顾性分析.
- 排除标准包括异常,凝血病,孤独,骨变形和年龄<18岁.
- 评估结果:手术时间,光镜时间,住院时间,无石头率和Clavien-Dindo并发症.
主要成果:
- 服用supine mPCNL的手术时间更短 (89.6分 vs 100.3分) 和住院时间更短 (60.7小时 vs 112.0小时).
- 整体并发症率相似,但主要并发症在易患组中较高 (p=0.041).
- 石块大小>25毫米和倾斜的位置是严重并发症的重要风险因素.
结论:
- 卧式和倾斜的mPCNL都对肥胖个体的结石有效.
- Supine mPCNL提供了优势,包括减少操作时间,辐射暴露,以及更少的重大并发症.
- 患有较大的石头或高并发性得分的患者需要仔细监测,因为风险增加.
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