迷你内镜联合内外科手术vs 皮肤性腎石切除术用于治疗复杂腎石症:一项随机对照试验
Ahmed Mohamed Tawfeek1, Ahmed Higazy1, Moatazbellah Mohamed Elkenany1
1Urology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Journal of endourology
|July 18, 2025
概括
迷你内镜联合内外科手术 (mECIRS) 与皮肤透腎石切除术 (PCNL) 相比,为复杂结石提供了更安全,更有效的单次治疗,并发症较少,恢复时间更短.
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:
- 复杂的结石在泌尿病学实践中构成了重大挑战.
- 穿皮瘤切除术 (PCNL) 是一种标准的治疗方法,但伴有并发症.
- 迷你内镜联合内手术 (mECIRS) 是一个新兴的替代方案.
研究的目的:
- 为了比较mECIRS与PCNL对复杂结石的疗效和安全性.
- 作为一个主要结果,评估单个会话无石头率 (SS-SFR).
- 评估二次结果,包括并发症,手术时间和住院时间.
主要方法:
- 一项随机对照试验,涉及100名患有Guy's Stone分数III或IV的患者.
- 患者被随机分配到PCNL或mECIRS中.
- 主要终点:1个月后A级SS-SFR;次要终点:并发症率 (Clavien-Dindo),手术时间,光镜时间,住院时间和成本.
主要成果:
- mECIRS在一次会议中显示出显著更高的A级SS-SFR (51%对32.6%,p=0.0275).
- mECIRS组的并发症率显著降低 (14.28%与38.77%,p=0.006),手术/光镜时间缩短.
- 辅助手术后的最终无石头率是可比的;mECIRS提供了更短的住院时间和相似的成本效益.
结论:
- mECIRS是复杂结石的安全有效治疗方法,其单次无结石率高于PCNL.
- 与标准PCNL相比,mECIRS与更少的并发症和更短的操作时间有关.
- mECIRS代表了治疗复杂结石的有利替代方案,为患者提供了更好的治疗结果.
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