输尿管肾镜治疗肾结石:一个中心的经验

Luísa Cerqueira, R. J. Cerqueira, Paulo Dinis
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摘要

在本研究中,我们评估了该手术在我院的初步结果,旨在评估逆行肾内手术的有效性和安全性以及该技术可能成功的预测因素。材料与方法:收集2014 - 2015年在圣若奥中心医院所有行逆行肾内手术患者的病历和影像学资料,应用我们的排除标准,对138例患者(共179例逆行肾内手术)的资料进行分析。我们研究的主要结果是手术的即时成功率(通过术中外科医生的感知来评估)和术后成功率(通过图像控制来评估)。残余结石b> 3mm。结果:考虑到外科医生的感知,总成功率为67.0%。考虑到图像控制,ICG外小于150mm2的结石成功率为66.7%,其他部位结石较小或结石较大。在单因素分析中,结石负担、结石数量和位置是逆行肾内手术成功的有统计学意义的预测因素。结论:ICG位置被认为是逆行肾内手术失败的一个预测因素,在这个位置,RIRS对结石< 150mm2更有效;ICG以外的结石没有出现这种差异。这是一种安全的干预措施,可以分阶段使用。
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Tratamento da Litíase Renal com Ureterorrenoscopia: Experiência de um centro
Introduction: In this study, we evaluated the initial results of this procedure in our hospital, aiming to evaluate retrograde intrarenal surgery efficacy and safety and possible success predictors of this technique. Material and Methods: After collecting data from the medical records and imaging studies of all patients undergoing retrograde intrarenal surgery in 2014 e 2015 at Centro Hospitalar de Sao Joao, and applying our exclusion criteria, we analyzed the data of 138 patients (total of 179 retrograde intrarenal surgery). The primary outcomes of our study were the immediate success rate, assessed by the surgeon’s perception intraoperatively, and postoperative success rate, assessed by image control. Residual lithiasis was considered significant in the presence of calculi > 3 mm. Results: The overall success rate was 67.0%, considering the surgeon’s perception. Considering the image control, the success rate was 66.7% for calculi smaller than 150 mm2 and located outside the ICG, but smaller in other locations or bigger calculi. In the univariate analysis, stone burden, calculi number and location were statistically significant predictors of retrograde intrarenal surgery success. Conclusion: Location in the ICG was considered a predictor of retrograde intrarenal surgery failure and, in this location, RIRS was more effective for calculi < 150 mm2; this differenced was not encountered for calculi outside the ICG. It is a safe intervention, which allows a staged use.
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