Single versus multiple mini-tract percutaneous nephrolithotomy for staghorn renal stone: A single-center study

IF 0.8 Q4 UROLOGY & NEPHROLOGY Urological Science Pub Date : 2022-01-01 DOI:10.4103/uros.uros_138_20
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Abstract

Purpose: Percutaneous nephrolithotomy (PCNL) is the standard procedure used for large kidney stones, and multiple tracts of PCNL are applied to achieve better stone clearance. However, the creation of multiple tracts may have the potential risk of bleeding and higher complication rates compared with single-tract procedures. We reviewed our experience managing staghorn calculi with multiple tracts compared with a single tract. Materials and Methods: Records of 36 patients with staghorn calculi who underwent PCNL at our institution between January 2018 and April 2020 were reviewed retrospectively. Nineteen patients were managed by single-tract access (Group 1), and 17 patients underwent multiple-tract access (Group 2). Both groups were compared in terms of perioperative findings and postoperative outcomes. Results: The mean number of percutaneous accesses in the multiple-tract group was 2.88, with most patients requiring two tracts. The mean duration of fluoroscopy screening and operative time was longer in Group 2. Stone-free rates were 59% and 70.5% in Groups 1 and 2, respectively. The mean hospital stay was similar in both groups. Complications included blood transfusion, resulting from a hemoglobin drop of 2.15 ± 0.96 and 1.59 ± 0.69 g/dL in Groups 1 and 2, respectively. Mean pre- and post-operative creatinine concentrations were 1.212 and 1.211 mg/dL in Group 1 and 1.206 and 1.157 mg/dL in Group 2. Mean changes in creatinine values were not statistically significant between the groups. Clavien–Dindo Classification Grade II complications included urosepsis and blood transfusion, which occurred in five patients in Group 1 and three in Group 2. Pseudoaneurysm attributed to Grade III complications occurred in one patient in Group 1. Conclusion: Multiple-tract access during PCNL is a safe and efficient method to manipulate staghorn kidney stones. Mini PCNL with multiple-tract access is a successful alternative to deal with staghorn stones involving multiple calyces.
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单路与多路经皮肾镜取石治疗鹿角型肾结石:一项单中心研究
目的:经皮肾取石术(PCNL)是治疗大面积肾结石的标准方法,应用多束PCNL可获得更好的结石清除率。然而,与单道手术相比,多道手术可能具有潜在的出血风险和更高的并发症发生率。我们回顾了我们治疗鹿角形结石的经验,与单路相比,多路鹿角形结石。材料和方法:回顾性分析2018年1月至2020年4月在我院接受PCNL治疗的36例鹿角形结石患者的记录。19名患者采用单路入路治疗(第1组),17名患者采用多路入路(第2组)。比较两组患者的围手术期表现和术后结果。结果:多通道组的平均经皮穿刺次数为2.88次,大多数患者需要两个通道。第2组荧光镜检查的平均持续时间和手术时间较长。第1组和第2组的结石清除率分别为59%和70.5%。两组患者的平均住院时间相似。并发症包括输血,第1组和第2组的血红蛋白分别下降2.15±0.96和1.59±0.69 g/dL。第1组术前和术后平均肌酸酐浓度分别为1.212和1.211 mg/dL,第2组分别为1.206和1.157 mg/dL。肌酸酐值的平均变化在两组之间没有统计学意义。Clavien–Dindo分级II级并发症包括尿脓毒症和输血,第1组发生5例,第2组发生3例。第1组中有一名患者出现了归因于III级并发症的假性动脉瘤。结论:经皮肾穿刺取石术是治疗鹿角形肾结石安全有效的方法。Mini PCNL伴多路入路是治疗涉及多个肾盏的鹿角形结石的成功替代方案。
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来源期刊
Urological Science
Urological Science UROLOGY & NEPHROLOGY-
CiteScore
1.20
自引率
0.00%
发文量
26
审稿时长
6 weeks
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