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在异常脏中吸入辅助小型化皮肤透膜利切除术的结果:一个多中心前性研究-一个EAU-Endurology合作
Vineet Gauhar1, Ee Jean Lim2, Bhaskar Kumar Somani3
1Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore.
Journal of endourology
|February 6, 2026
概括
吸入辅助迷你PCNL (SM-PCNL) 在异常脏中的结石中提供高无结石率 (93.4%). 这种技术表现出较低的并发症率,使其成为复杂结石病例的安全选择.
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:
- 异常脏中的结石由于解剖学变异而存在独特的外科手术困难.
- 微型皮肤穿神经切除术 (mini-PCNL) 是一种侵入性较小的选择,但人们仍然担心无结石率和感染.
- 吸入辅助迷你PCNL (SM-PCNL) 可能会改善碎片去除和压力控制,但其在异常脏中的有效性需要进一步研究.
研究的目的:
- 评估SM-PCNL在患有位于异常脏中的结石的患者的现实世界外科结局.
- 分析患者定位,石术方法以及特定的异常如何影响SM-PCNL结果.
- 评估SM-PCNL在多中心环境中的安全性和有效性.
主要方法:
- 一项前性多中心研究,涉及287名成年患者接受SM-PCNL治疗异常脏中的结石.
- 排除标准包括正常的脏解剖,非吸收PCNL和不完整的数据.
- 无石头率 (SFR) 通过30天的无对比CT扫描来确定,将患者分为A级 (100%无石头),B级 (≤4毫米残留碎片) 或C级 (>4毫米残留碎片/需要重新干预).
主要成果:
- 不良旋转 (65.5%) 是最常见的异常,其次是双重系统 (25.1%).
- 在30天的总体无石头率为93.4% (A级),只有1.0%需要重新干预.
- 并发症是最小的,包括需要ICU入院的0.7%的败血症率;没有报告输血或胸膜损伤.
结论:
- SM-PCNL,特别是用单阶段的18F吸和激光石化术,实现了93.4%的高完全无石率.
- 该程序与微不足道的并发症和对异常脏的重新干预的低需求有关.
- SM-PCNL代表了复杂的结石病例的安全和有效的治疗选择,涉及解剖学异常.
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