内镜联合内外科手术与易患复杂结石的皮肤穿神经切除术:随机试验的批判性评估
Kareem Noah1,2, Khaled Algamal3, Tarek Elliethy4
1Urology Department, University Hospitals Coventry and Warwickshire, Coventry, UK. kareem.noah@uhcw.nhs.uk.
International urology and nephrology
|March 29, 2025
概括
在Galdakao-Modified Supine Valdivia (GMSV) 位置的内镜联合内手术 (ECIRS) 对复杂结石的立即成功率高于易患皮肤穿神经切除术 (PCNL). 通过ECIRS,通过更少的穿刺和更短的手术时间,改善了结果.
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
- 腎石病的管理方法
背景情况:
- 复杂的结石是一个重大管理挑战.
- 卧卧的皮肤透神经切除术 (PCNL) 是一种标准的治疗方法.
- 正在探索替代的外科位置和技术,以改善结果.
研究的目的:
- 为了比较内镜联合内外科手术 (ECIRS) 在Galdakao-Modified Supine Valdivia (GMSV) 位置的疗效和安全性,与常规PCNL在倾斜的位置.
- 评估治疗复杂结石的结果.
主要方法:
- 一项前性随机研究,涉及60名患有复杂结石的患者.
- 患者被分配到躺着的PCNL或在GMSV位置的ECIRS.
- 收集的数据包括人口特征,临床结果,外科手术期间的参数和无结石率 (SFR).
主要成果:
- 与PCNL组 (119±18分钟) 相比,ECIRS组的操作时间 (105±14分钟) 显著更长.
- 在PCNL组中,穿孔的数量明显更高.
- 与PCNL组 (53.3%) 相比,在ECIRS组 (83.3%) 中,立即无结石率显著更高.
结论:
- 位于GMSV位置的ECIRS是复杂结石的高效治疗方法.
- ECIRS提供了有利的结果,包括更高的单级无石头率.
- 与易患PCNL相比,ECIRS与较低的不良事件发生率和减少对辅助程序的需求有关.
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