Comparative analysis of retrograde intrarenal surgery and modified ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm)

Autor: Weibin Xie, Li Huang, Cheng Liu, Cong Lai, Zhuohang Li, Kuiqing Li, Hao Yu, Kewei Xu, Arvind Kumar Shah
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Urology
medicine.medical_treatment
030232 urology & nephrology
Nephrolithotomy
Percutaneous
Retrograde intrarenal surgery
lcsh:RC870-923
Kidney Calices
Patient Positioning
Lower pole stones
03 medical and health sciences
chemistry.chemical_compound
Hemoglobins
Kidney Calculi
Young Adult
0302 clinical medicine
Postoperative Complications
medicine
Operating time
Ureteroscopy
Humans
Percutaneous nephrolithotomy
Aged
Nephrostomy
Percutaneous
Retrospective Studies
Creatinine
business.industry
Lower pole
General Medicine
Length of Stay
Middle Aged
lcsh:Diseases of the genitourinary system. Urology
Treatment efficacy
Surgery
Lithotomy position
Semi-supine combined lithotomy position
Treatment Outcome
Reproductive Medicine
chemistry
030220 oncology & carcinogenesis
Modified ultra-mini percutaneous nephrolithotomy
Female
Mini percutaneous nephrolithotomy
business
Perfusion
Research Article
Zdroj: BMC Urology
BMC Urology, Vol 20, Iss 1, Pp 1-7 (2020)
ISSN: 1471-2490
Popis: Background To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and modified Ultra-mini percutaneous nephrolithotomy (UMP) in semi-supine combined lithotomy position for the management of 1.5–3.5 cm lower pole renal stones (LPSs). Methods A total of 63 patients with 1.5–3.5 cm LPSs who underwent RIRS (n = 33) or modified UMP (n = 30) in diameter between January 2017 and January 2019 were analyzed retrospectively. Modified UMP was performed in semi-supine combined lithotomy position and a 9.5/11.5 F ureteral access sheath (UAS) was inserted during the procedure in order to maintain low pelvic pressure and to facilitate the removal of stone fragments. Base-line parameters, stone characteristics, illness condition, operation time, postoperative hemoglobin (Hb) drop, postoperative creatinine (Cr) elevation, length of hospital stay, length of postoperative hospital stay, stone-free rate (SFR) and complications were compared between the two groups. Results There were no significant differences between the two groups in base-line parameters, stone characteristics and illness condition. The mean operating time of RIRS group was longer than UMP group (95.61 ± 21.9 vs. 55.0 ± 16.1 min, p p p p p p = 0.504, p = 0.675). There were no significant differences between the two groups in complications (p = 0.228). Conclusion For patients with 1.5–3.5 cm LPSs, both modified UMP and RIRS are safe and viable. The modified UMP technique was used in this study, application semi-supine combined lithotomy position and the retention of UAS can improve the surgical efficiency and maintain low pressure perfusion in the kidney, which resulted in superior treatment efficacy. Therefore, we highly recommend this technique for LPSs with heavy stone burdens.
Databáze: OpenAIRE
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