一项随机比较的研究,研究了柔性尿路管透镜与微型皮肤利切除术,用于治疗2厘米或更小的结石
Amr E Darwish1, Alaa E Abdel Moneim1, Abdelfatah I Ahmed1
1Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt.
Current urology
|April 21, 2025
概括
迷你透皮瘤切除术 (mPCNL) 与柔性尿道镜术 (fURS) 相比,在2厘米以下的结石中提供更高的初始成功率. 然而,mPCNL与比fURS更频繁的并发症有关.
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.
- 腎石病的治療方法
背景情况:
- 灵活的尿道透镜 (fURS) 和迷你透皮利切除术 (mPCNL) 是对结石的常见治疗方法.
- 目前的指导方针缺乏关于在fURS和mPCNL之间做出选择的最终建议.
- 这项研究将fURS与mPCNL的安全性和有效性与2厘米以下的结石进行比较.
研究的目的:
- 为了比较fURS和mPCNL治疗结石≤2厘米的初始和最终成功率.
- 评估和比较fURS和mPCNL之间的并发症率.
- 评估二次结果,包括手术时间,辅助手术,输血率和住院时间.
主要方法:
- 从2019年1月到2021年7月进行了一项前性随机比较研究.
- 成年患者的结石≤2厘米,不适合或失败的体外冲击波石,被随机分配到mPCNL或fURS.
- 结果包括最初的成功率,修改的克拉维恩-丁多并发症,最终的成功率,手术时间和停留时间.
主要成果:
- 迷你透皮瘤切除术的初始成功率 (93%) 与灵活的尿路管透镜 (70%) 相比显著更高.
- 与fURS (18.6%) 相比,mPCNL (44.1%) 的并发症率明显高.
- 两个治疗组之间的最终成功率,手术时间和住院时间是可比的.
结论:
- 迷你透皮结石切除作为结石<2厘米的单步治疗更有效,因为其最初的成功率更高.
- 与mPCNL相比,灵活的尿路尿镜与较低的并发症率有关.
- 在mPCNL和fURS之间的结石≤2厘米的选择涉及到有效性与并发症风险的平衡.
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