Standard Vs Mini-Percutaneous Nephrolithotomy for Staghorn Stones

N. Sultan, N. Khan, A. Aziz, Mian Shabbir Ahmed
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Abstract

Objective: Objective of this study was to compare the effectiveness of standard and mini-percutaneous nephrolithotomy in treating staghorn stones Methodology: From July 2017 to June 2019, In Institute Of Kidney Diseases (PGMI) Hayatabad Medical Complex Peshawar a tertiary care hospital we conducted a randomized controlled trial to determine the stone-free rate for patients with staghorn stones (Total duration of the study was 2 years). The trial included 150 patients separated into two groups: one that received standard- and mini-PCNL surgeries. Each patient was randomly assigned to undergo one of the two procedures, with 50% receiving standard PCNL and the other 50% mini-PCNL. Durations of surgical procedures, length of hospital stay, complications, and pain levels were all measured during the study. Result: 150 patients with a mean age of 51.2 years (range, 18-85 years) were included in this research. 88% of the participants were men and 16% were women. Success rates for standard PCNL and mini-PCNL were 97.3% and 90.7%, respectively (p=0.04). Additionally, compared to the standard-PCNL group (105.3 minutes and 3.3 days, respectively), the mini-PCNL group had a considerably reduced mean operation time (80.2 minutes) and a shorter mean hospital stay (2.2 days) (p 0.001). Standard PCNL also had a higher overall complication rate than mini-PCNL (26% vs. 13%, p = 0.038). In addition, the mini-PCNL group had considerably less postoperative discomfort (p 0.001). Conclusion: When controlling staghorn stones, Mini-PCNL has shown to be a reliable and safe solution that offers a number of benefits over conventional Standard-PCNL. Mini-PCNL clearly outperforms standard PCNL in terms of lowering postoperative pain, hospital stays, and operating room time. As a result, Mini-PCNL is gradually becoming into the preferred operational strategy for effectively controlling staghorn stones. Keywords: Percutaneous nephrolithotomy, staghorn stones, stone-free rate, surgical time, hospital stay, complications, postoperative discomfort.
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标准与微型经皮肾镜取石术治疗鹿角石
目的:本研究的目的是比较标准和微型经皮肾镜取石术治疗鹿角结石的有效性。方法:2017年7月至2019年6月,在白沙瓦三级医院肾脏疾病研究所(PGMI) Hayatabad医疗中心,我们进行了一项随机对照试验,以确定鹿角结石患者的结石清除率(研究总持续时间为2年)。该试验包括150名患者,分为两组:一组接受标准和迷你pcnl手术。每个患者被随机分配接受两种手术之一,50%接受标准PCNL,另外50%接受迷你PCNL。研究期间测量了手术时间、住院时间、并发症和疼痛程度。结果:150例患者纳入本研究,平均年龄51.2岁(范围18-85岁)。88%的参与者是男性,16%是女性。标准PCNL和迷你PCNL的成功率分别为97.3%和90.7% (p=0.04)。此外,与标准pcnl组(分别为105.3分钟和3.3天)相比,迷你pcnl组的平均手术时间(80.2分钟)和平均住院时间(2.2天)显著缩短(p 0.001)。标准PCNL的总并发症发生率也高于迷你PCNL(26%比13%,p = 0.038)。此外,mini-PCNL组术后不适明显减少(p < 0.001)。结论:在控制鹿角石时,Mini-PCNL已被证明是一种可靠和安全的解决方案,与传统的标准pcnl相比,它提供了许多好处。Mini-PCNL在降低术后疼痛、住院时间和手术室时间方面明显优于标准PCNL。因此,Mini-PCNL逐渐成为有效控制鹿角石的首选操作策略。关键词:经皮肾镜取石术,鹿角结石,结石清除率,手术时间,住院时间,并发症,术后不适。
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