2 ~ 4cm肥胖肾结石患者经皮肾镜取石与逆行柔性肾镜取石的比较

Q4 Medicine Nephro-urology Monthly Pub Date : 2022-11-13 DOI:10.5812/numonthly-132180
M. Hamidi, Seyed Saeed Tamehri Zadeh, A. Samadi, Farshad Namdari, A. Khajavi, Alimohammad Fakhr Yasseri, S. Aghamir
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引用次数: 0

摘要

背景:如今,由于逆行肾内手术(RIRS)的显著进展,人们对该手术作为肾结石治疗的第二种或替代选择给予了适度的关注。目的:在本研究中,我们比较了RIRS和经皮肾取石术(PCNL)治疗肥胖合并2-4 cm肾结石患者的疗效。方法:将2015年6月至2018年12月在新浪医院泌尿外科接受PCNL(n=40)和RIRS(n=42)治疗的82名患者纳入我们的回顾性队列研究。结果:第一次手术后,RIRS组的结石清除率为92.9%,PCNL组为95%(P值=0.52)。RIRS组和PCNL组的平均手术时间分别为71.6±11和93.3±12.2(P<0.001);然而,大多数RIRS组的镇痛时间不到1天(P<0.001)。RIRS组镇痛药的使用量显著低于PCNL组(分别为9.0±5.5、61.8±13.6;P<0.001。结论:根据RIRS组获得的满意结果,可以得出结论,RIRS可以作为2-4cm肾结石肥胖患者的替代甚至首选。
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Comparison Between Percutaneous Nephrolithotomy and Retrograde Flexible Nephrolithotripsy in Obese Patients with 2 - 4 cm Renal Stones
Background: Nowadays, because of remarkable advancements in retrograde intrarenal surgery (RIRS), modest attention toward this procedure as the second or alternative choice for renal stones treatment has been drawn. Objectives: In the present study, we compared RIRS and percutaneous nephrolithotomy (PCNL) outcomes in treating obese patients with 2 - 4 cm renal stones. Methods: Eighty-two patients who underwent PCNL (n = 40) and RIRS (n = 42) between June 2015 and December 2018 at the Department of Urology of Sina Hospital were enrolled in our retrospective cohort study. Results: After the first surgery session, stone-free rates for the RIRS group were 92.9% and for the PCNL group was 95% (P value = 0.52). The mean operation time for the RIRS and PCNL groups were 71.6 ± 11 and 93.3 ± 12.2, respectively (P < 0.001). The hospitalization stay for all of the PCNL group was more than 1 day (mean = 2.5 days); however, that for the majority of the RIRS group was less than 1 day (P < 0.001). The analgesic use in the RIRS group was significantly lower than in the PCNL group (9.0 ± 5.5, 61.8 ± 13.6, respectively; P < 0.001). The overall complication rates were higher in the RIRS group. However, none of them were statically significant (P > 0.05). Conclusions: According to satisfactory outcomes obtained in the RIRS groups, it can be concluded that RIRS can be applied as an alternative or even the first choice in obese patients with 2 - 4 cm renal stones.
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来源期刊
Nephro-urology Monthly
Nephro-urology Monthly Medicine-Urology
CiteScore
0.40
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26
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