Comparsion of Outcomes of Single Versus Multiple Mini-Tract Percutaneous Nephrolithotomy for Staghorn Renal Stone Clearance

Tariq Ijaz, Bakhtawar Gul Wazir, Mohammad Asad Shamsher
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Abstract

Background: Staghorn calculi are branched stones that contain extra than Failure to cast off staghorn calculus might also additionally ruin the parenchyma and kidney feature and motive life-threatening sepsis. Therefore, whole elimination and clearance rates are more often than not taken into consideration while managing staghorn stones. The aim of this study was to investigate the efficacy and safety of multi-tract percutaneous nephrolithotomy (PNL) against the benchmark of the single tract approach. Material and Methods: A randomized clinical trial was conducted at institute of kidney disease Peshawar “between 1stMarch 2022 to 31st Oct 2022” after fulfilling the inclusion criteria. A total 100 patients were included in this study using consecutive non portability sampling technique. Patients who received single- or multiple-tract mPCNL depended on the stone complexity of their computed tomography (CT) images before the operation. In addition, 50 patients who underwent the single mini-tract (<21-Fr sheath) percutaneous method (Group A) compared with 50 patients who required multiple (≥2) mini tracts (Group 2) Results: A total 100 patients with staghorn calculi (Male 33(57.8%) , Female 21(48.8%) and Male 23 (40.3%) , Female 22 (51.1% ) were treated with two types of tracts for mini PCNL, i.e single- and multiple-tract mini PCNL, respectively. The mean stone size was in single tract was 12.67±8.06 and multiple tracts was 17.23±10.49; a significant difference in stone size in Groups A and B, respectively; (P = 0.005). In addition, the Stone Hounsfield unit means score in single tract was 919.73 and multiple tracts were 1070.11. S. T. O. N. E. score in Group 2 was significantly higher (8.4±1.7 10.6±1.3 = 0.001). Practical Implication: In this study a multi-tract PCNL has been shown to be an effective and secure expansion of a single-tract PCNL for big stone burden and complex kidney stone disease. The benefit of this study was to investigate the efficacy and safety of multi-tract percutaneous nephrolithotomy (PNL) against the benchmark of the single tract approach. Conclusion: A multi-tract PCNL has been shown to be an effective and secure expansion of a single-tract PCNL for big stone burden and complex kidney stone disease in this randomised clinical trial single-center investigation. Future prospective studies should concentrate on how well the technique can help individuals with severe stone disease require fewer interventions before becoming stone-free. Keywords: Multiple-Tract, Percutaneous Nephrolithotomy, Staghorn Calculi, Kidney Stone Disease,
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单路与多路经皮肾镜取石术清除鹿角型肾结石的效果比较
背景:鹿角结石是一种含有更多结石的分支结石,如果不能排出鹿角结石,还可能破坏肾实质和肾脏特征,引起危及生命的脓毒症。因此,在处理鹿角石时,通常要考虑到整体清除率和清除率。本研究的目的是探讨多道经皮肾镜取石术(PNL)与单道取石术的疗效和安全性。材料和方法:在符合纳入标准后,于2022年3月1日至2022年10月31日在白沙瓦肾脏疾病研究所进行了一项随机临床试验。本研究共纳入100例患者,采用连续非携带取样技术。接受单束或多束mPCNL的患者取决于术前计算机断层扫描(CT)图像的结石复杂性。结果:共100例鹿角形结石患者(男33例(57.8%),女21例(48.8%),男23例(40.3%),女22例(51.1%),分别采用单路和多路微型PCNL两种类型的管道进行治疗。单道结石平均大小为12.67±8.06,多道结石平均大小为17.23±10.49;a组和B组的结石大小差异显著;(p = 0.005)。此外,Stone Hounsfield单位均值在单束为919.73分,多束为1070.11分。S. T. O. N. e评分显著高于对照组(8.4±1.7 10.6±1.3 = 0.001)。实际意义:在本研究中,对于大结石负担和复杂肾结石疾病,多路PCNL已被证明是单路PCNL的有效和安全扩展。本研究的好处是对比单道入路的基准,探讨多道经皮肾镜取石术(PNL)的疗效和安全性。结论:在这项单中心随机临床试验中,多道PCNL已被证明是对大结石负担和复杂肾结石疾病的单道PCNL的有效和安全的扩展。未来的前瞻性研究应该集中在这项技术如何帮助患有严重结石疾病的人在没有结石之前需要更少的干预。关键词:多尿路,经皮肾镜取石术,鹿角结石,肾结石疾病,
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