Comparison of Standard Percutaneous Nephrolithotomy with Mini-Percutaneous Nephrolithotomy for Removal of Renal Stones in Adults

A. Alam Khan, I. Malkani, Junaid Jameel Khattak, H. Mumtaz, Mubashir Mazhar, F. Naz, Arsalan Riaz
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引用次数: 1

Abstract

Renal stones are the third most common problem affecting about 10% of global population. The management of nephrolithiasis has undergone a complete transformation since the 1980s. Percutaneous nephrolithotomy (PCNL) has established itself an effective and safe technique that delivers high stone-free rate as well as overall shorter treatment time. We aim to compare the outcome of mini-PCNL with standard-PCNL in patients presenting with renal stones. In all, 90 patients fulfilled the selection criteria and randomized into two groups. Group A underwent mini-PCNL whereas Group B underwent standard-PCNL. Pre-operative hemoglobin level was recorded. Duration of procedure as well as drop in hemoglobin level was also recorded. A kidney, ureter, and bladder (KUB) X-ray was performed to confirm the presence of of stone and stone-free status. The mean age of patients in mini-PCNL group was 43.11 years and in standard-PCNL group, it was 36.91 years. The mean stone size in patients of mini-PCNL group was 29.53 mm and 31.58 mm in standard-PCNL group. The mean duration of renal stone in mini-PCNL group was 1.91 years and that in standard-PCNL group 1.80 years. The mean operative time in mini-PCNL group was 59.56 min and 61.22 min in standard-PCNL group. The mean fall in hemoglobin in mini-PCNL group was 0.38 g/dL and that in standard-PCNL group 0.51 g/dL. In mini-PCNL group, stone clearance was observed in 42 (93.3%) patients, while in standard-PCNL group, it was observed in 45 (100%) patients. This difference was insignificant (P > 0.05). Mini-PCNL and standard-PCNL have no significant differences in terms of outcome, operative time, and stone clearance, although fall in hemoglobin level was less in mini-PCNL group, which showed less blood loss in this group, thereby making it a more appropriate method for renal stone removal.  
标准经皮肾镜取石术与微型经皮肾镜取石术治疗成人肾结石的比较
肾结石是影响全球约10%人口的第三大常见问题。自20世纪80年代以来,肾结石的治疗经历了彻底的转变。经皮肾镜取石术(PCNL)是一种有效且安全的技术,具有高结石去除率和较短的治疗时间。我们的目的是比较迷你pcnl和标准pcnl在肾结石患者中的预后。共有90例患者符合选择标准,随机分为两组。A组行迷你pcnl, B组行标准pcnl。记录术前血红蛋白水平。同时记录手术时间和血红蛋白水平的下降。行肾、输尿管和膀胱(KUB) x线检查以确认结石和无结石的存在。迷你pcnl组患者平均年龄为43.11岁,标准pcnl组患者平均年龄为36.91岁。迷你pcnl组患者的平均结石大小为29.53 mm,标准pcnl组患者的平均结石大小为31.58 mm。迷你pcnl组肾结石的平均持续时间为1.91年,标准pcnl组为1.80年。迷你pcnl组平均手术时间为59.56 min,标准pcnl组平均手术时间为61.22 min。迷你pcnl组血红蛋白平均下降0.38 g/dL,标准pcnl组血红蛋白平均下降0.51 g/dL。mini-PCNL组有42例(93.3%)患者结石清除,而标准pcnl组有45例(100%)患者结石清除。差异不显著(P > 0.05)。Mini-PCNL组与标准pcnl组在预后、手术时间、结石清除等方面无显著差异,但Mini-PCNL组血红蛋白水平下降较少,出血量较少,是更合适的肾结石清除方法。
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