推进信封:对于患有复杂脏结石的患者的门诊性皮肤内切除术
Christopher Connors1, Kavita Gupta1, So Yeon Pak2
1Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Journal of endourology
|February 11, 2025
概括
复杂结石的门诊性皮肤穿神经切除术 (PCNL) 与住院患者相比,显示出相似的安全性和无结石率. 对于被选中的高风险个体来说,同日出院是可行的.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术创新 在外科创新.
背景情况:
- 门诊性皮肤穿神经切除术 (PCNL) 对于简单的结石越来越受欢迎.
- 它在复杂的结石中的应用仍然不太了解.
- 评估复杂石PCNL的当天排放安全性至关重要.
研究的目的:
- 为了评估当天出院 (行医) 与PCNL治疗复杂结石后入院的安全性和有效性.
- 为了比较并发症率,再入院率,急诊室访问率和无石头率 (SFR).
主要方法:
- 在2019年4月至2021年1月期间,对接受PCNL治疗复杂结石的成年患者进行了回顾性研究 (Guy's Stone 评分≥3或STONE 结石测试评分≥9).
- 同一天出院的患者和手术后入院的患者之间的结局比较.
- 分析包括术后第一天 (POD#1) 和30天的并发症,再入院,急救诊所和SFRs.
主要成果:
- 分析了79名门诊和111名住院患者;只有1名门诊患者需要入院.
- 30天并发症率 (20.3%对25.2%) 和POD#1并发症 (1.3%对7.2%) 并没有显著不同.
- 门诊患者有更高的无再入院ED访问的可能性 (8.9%对1.8%),但类似的再入院率 (5.1%对9.9%).
- 没有石头的比率是可比的 (80.6%与70.6%).
结论:
- 在PCNL治疗复杂结石后,同日出院的患者与住院患者相比,具有相似的安全性和SFR.
- 门诊PCNL对于精心挑选的高风险患者来说是一个可行的选择.
- 这种方法可以帮助优化资源利用,而不会影响患者的治疗结果.
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