First 100 Reported Cases of Supine Percutaneous Nephrolithotomy in Malaysia: An Alternative Effective and Safe Approach to Treat Renal Stones.

IF 1.1 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Malaysian Journal of Medical Sciences Pub Date : 2024-06-01 Epub Date: 2024-06-27 DOI:10.21315/mjms2024.31.3.9
Han Kun Ng, Chee Hoong Loo, Meng Shi Lim
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引用次数: 0

Abstract

Background: Supine percutaneous nephrolithotomy (s-PCNL) offers great benefits from urological and anaesthetic points of view. We present the first evaluation of the outcomes of s-PCNL in Malaysia. Our aim was to explore the safety and efficacy of s-PCNL.

Methods: Institutional review board approval was obtained from the National Medical Research Register (NMRR ID-21002225-WLP). We retrospectively reviewed 115 patients with renal pelvis stones who underwent single renal access during s-PCNL between November 2020 and May 2023. Patients who underwent simultaneous ipsilateral or contralateral endourological procedures were included. The data were analysed to determine stone-free rates (SFR), major complication rates, blood transfusion rates, operative times and lengths of hospital stay (LOS).

Results: The SFR was higher for the single middle calyceal renal access (MCA) group than for the lower calyceal renal access (LCA) or upper calyceal renal access (UCA) groups (OR: 1.76; 95% confidence interval [CI]: 0.63, 4.92). In total, 0, 1 and 2 patients had major complications in the UCA, MCA and LCA groups, respectively (P = 0.453). One of the 115 patients (0.9%) needed blood transfusion. Subgroup analysis revealed mean operative times of 76.3 min and 78.6 min for patients who underwent sole s-PCNL (PCNL-only group) and those who had simultaneous ipsilateral and contralateral endourological procedures (PCNL-plus group), respectively (P = 0.786). The overall mean LOS was 2.9 days.

Conclusion: s-PCNL is a safe and effective alternative treatment for renal stones. We would recommend s-PCNL for patients who require an ipsilateral/contralateral endourological procedure (URS/RIRS) because it is time-efficient. All renal accesses are safe. Single MCA is recommended for complete stone clearance.

马来西亚首100例报告的仰卧位经皮肾镜取石术:治疗肾结石的另一种有效而安全的方法。
背景:仰卧位经皮肾镜取石术(s-PCNL)从泌尿外科和麻醉学的角度来看都有很大的优势。我们首次在马来西亚对仰卧位经皮肾镜取石术的效果进行了评估。我们的目的是探讨 s-PCNL 的安全性和有效性:方法:我们从国家医学研究登记处(NMRR ID-21002225-WLP )获得了机构审查委员会的批准。我们对2020年11月至2023年5月期间接受s-PCNL手术的115名肾盂结石患者进行了回顾性研究。我们纳入了同时接受同侧或对侧腔内手术的患者。对数据进行分析,以确定无结石率(SFR)、主要并发症发生率、输血率、手术时间和住院时间(LOS):单一中肾盏入路(MCA)组的无结石率(SFR)高于下肾盏入路(LCA)或上肾盏入路(UCA)组(OR:1.76;95% 置信区间[CI]:0.63, 4.92)。在 UCA、MCA 和 LCA 组中,分别有 0、1 和 2 名患者出现主要并发症(P = 0.453)。115名患者中有1人(0.9%)需要输血。亚组分析显示,仅接受 s-PCNL 的患者(仅 PCNL 组)和同时接受同侧和对侧腔内手术的患者(PCNL-plus 组)的平均手术时间分别为 76.3 分钟和 78.6 分钟(P = 0.786)。结论:s-PCNL 是一种安全有效的肾结石替代治疗方法。结论:s-PCNL 是一种安全、有效的肾结石替代治疗方法。对于需要进行同侧/对侧内镜手术(URS/RIRS)的患者,我们推荐使用 s-PCNL,因为它节省时间。所有肾脏入路都是安全的。为彻底清除结石,建议采用单一 MCA。
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来源期刊
Malaysian Journal of Medical Sciences
Malaysian Journal of Medical Sciences MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
2.70
自引率
0.00%
发文量
89
审稿时长
9 weeks
期刊介绍: The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access, fully online journal that is published at least six times a year. The journal’s scope encompasses all aspects of medical sciences including biomedical, allied health, clinical and social sciences. We accept high quality papers from basic to translational research especially from low & middle income countries, as classified by the United Nations & World Bank (https://datahelpdesk.worldbank.org/knowledgebase/ articles/906519), with the aim that published research will benefit back the bottom billion population from these countries. Manuscripts submitted from developed or high income countries to MJMS must contain data and information that will benefit the socio-health and bio-medical sciences of these low and middle income countries. The MJMS editorial board consists of internationally regarded clinicians and scientists from low and middle income countries.
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