逆行肾内手术中下极肾盏结石与其他肾盏结石的游离率

R. Shah, Tika Devi Kandel, D. Adhikari
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引用次数: 0

摘要

背景:内镜器械的小型化在肾结石的治疗中得到了广泛的应用。与其他治疗方式相比,逆行肾内手术(RIRS)和激光联合治疗肾结石已经证明了其优越性。本研究旨在评估RIRS患者下极肾盏结石与其他极肾盏结石的无石率(SFR)。方法:本回顾性研究分析了2021年3月至2022年2月在尼泊尔奇旺医学院和教学医院接受逆行肾内手术(RIRS)的15岁以上成人中,下极肾盏结石与其他极肾盏结石的游离率。对术后并发症、结石大小、手术时间、住院时间和是否需要第二次手术进行描述性评估。结果:62例患者行逆行肾内手术。低钙组平均年龄为38.41±10.54岁,低钙组平均年龄为39.09±13.53岁,p值为0.829。下盏结石的平均hounsfield为1023.31±252.96,其他盏结石的平均值为1004.00±349.22,p值为0.806。下盏结石大小为11.07±2.10 mm,其他盏结石大小为10.67±2.51mm, p值为0.507。第一组手术时间为63.82±23.57min,第二组为65.93±28.96 min, p值为0.756。下盏结石住院时间为6.13±1.43天,其他盏结石住院时间为5.87±0.99天,p值为0.412,差异有统计学意义。两臂均无重大并发症。下盏结石游离率为25(86.2%),其他盏结石游离率为31(93.93%),p值为0.405,差异无统计学意义。结论:逆行肾内手术是一种更好的治疗方法,并不断取得重大进展。这是一种技术上安全有效的治疗方法,治疗下极肾盏结石,术后发病率和结石清除率最佳。
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Stone Free Rate of Lower Pole Calyceal Stone Versus Other Calyces in Retrograde Intrarenal Surgery
Background: Miniaturization of endoscopic instruments has gained wide popularity in the treatment of renal calculi. Retrograde intra-renal surgery (RIRS) and laser in combination has already proven their superiority when compared to other modalities in the treatment of renal calculi. This study was conducted to assess the stone-free rate (SFR) of lower pole calyceal stone versus other pole calyces in RIRS.  Methods: This retrospective study analyzed the stone free rate of lower pole calyx stone versus other pole calyces in retrograde intra renal surgery (RIRS) adults above 15 years of age from March 2021 to February 2022 at Chitwan Medical College and Teaching Hospital, Nepal. The stone-free rate was assessed descriptively on post operative complications, stone size, operative time, hospital stay, and need for the second procedure. Results: A total of 62 patients underwent retrograde intrarenal surgery. The mean age of the study population was 38.41 ± 10.54years in the lower caliceal group against 39.09 ±13.53 years with p value of 0.829.The mean hounsfield of lower caliceal stone was 1023.31±252.96 to that of other caliceal stones 1004.00±349.22 with p value of 0.806.  The sizes of the stones were 11.07±2.10 mm in lower caliceal stones versus 10.67±2.51mm in other caliceal stones with p value of 0.507. The duration of operation time in 1st group was 63.82±23.57minutes to that of 65.93±28.96 in 2nd group with p value of 0.756. The hospital stay in lower caliceal stones were 6.13±1.43days to that of other caliceal stones 5.87±0.99 with significant p value of 0.412. There were no major complications in both arms. The stone free rate was 25 (86.2%) in lower caliceal stones as compared to 31(93.93%) in other caliceal stones with no significant p value of 0.405.     Conclusions: Retrograde intrarenal surgery is a better procedure that continues to undergo significant advancements. It is a technically safe and effective procedure for the treatment option for treating the lower pole calyx calculus with optimal post-surgical morbidity and stone-free rate.
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