Comparison of standard percutaneous nephrolithotomy and total tubeless percutaneous nephrolithotomy in the supine position.

IF 2 2区 医学 Q2 UROLOGY & NEPHROLOGY Urolithiasis Pub Date : 2024-06-04 DOI:10.1007/s00240-024-01580-5
Çağdaş Bildirici, Taha Çetin, Mehmet Yiğit Yalçın, Mert Hamza Özbilen, Erkin Karaca, Mahmut Can Karabacak, Mehmet Çağlar Çakıcı, Tufan Süelözgen, Gökhan Koç
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Abstract

Purpose: To compare the efficacy, safety and advantages of the total tubeless (TT) percutaneous nephrolithotomy (PCNL) and standard PCNL in the supine position.

Methods: This study was carried out at İzmir Tepecik Health Application and Research Center. A total of 87 patients were examined. Forty-three patients who underwent TT procedure were defined as Group 1, and 44 patients who underwent standard procedure with a nephrostomy tube were defined as Group 2. Two techniques were evaluated with demographic data and outcome parameters. Univariate regression analyses were performed in these data sets for the parameters that predicted the TT procedure.

Results: The demographic data of the groups and all characteristics of the stones were similar. When the results were examined, the stone-free rates detected by non-contrast computed tomography (CT) in the postoperative 1st month were similar between the groups. Complication rates and secondary intervention rates were similar. Operation and fluoroscopy times were shorter in group 1, which were not statistically significant. Postoperative hemoglobin decreased, and creatinine values were similar. In Group 1, mean postoperative visual analog scale (VAS) scores and the percentage of VAS reporting > 5 points for pain level measurement were lower and statistically significant. In the univariate analysis of the factors predicting the TT procedure, no significant results were found in any parameter.

Conclusion: Performing TT PCNL in the supine position in selected patients reduces postoperative pain without affecting the complication rates as in prone PCNL. Our study is the first to compare TT and standard PCNL in supine position.

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标准经皮肾镜碎石术与仰卧位全无管经皮肾镜碎石术的比较。
目的:比较仰卧位全无管(TT)经皮肾取石术(PCNL)和标准 PCNL 的疗效、安全性和优势:本研究在伊兹密尔泰佩契克健康应用与研究中心进行。共有 87 名患者接受了检查。43名接受TT手术的患者被定义为第一组,44名接受标准手术并使用肾造瘘管的患者被定义为第二组。对这些数据集中预测 TT 手术的参数进行了单变量回归分析:结果:各组的人口统计学数据和结石的所有特征均相似。检查结果显示,两组患者在术后第一个月通过非对比计算机断层扫描(CT)检测到的无结石率相似。并发症发生率和二次干预率相似。第一组的手术和透视时间更短,但无统计学意义。术后血红蛋白下降,肌酐值相似。在第一组中,术后视觉模拟量表(VAS)平均评分和 VAS 疼痛程度测量报告>5 分的百分比较低,且有统计学意义。在对预测 TT 手术的因素进行的单变量分析中,没有发现任何参数有显著性结果:结论:对选定的患者采取仰卧位进行 TT PCNL 可减少术后疼痛,但不会影响俯卧 PCNL 的并发症发生率。我们的研究首次对仰卧位 TT PCNL 和标准 PCNL 进行了比较。
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来源期刊
Urolithiasis
Urolithiasis UROLOGY & NEPHROLOGY-
CiteScore
4.50
自引率
6.50%
发文量
74
期刊介绍: Official Journal of the International Urolithiasis Society The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field. Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.
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