The association between novel negative pressure ureteroscopic lithotripsy combined with flexible ureteroscopy versus percutaneous nephrolithotomy on stone-free rates: implications for clinical practice and policy.

IF 2 2区医学 Q2 UROLOGY & NEPHROLOGY

Urolithiasis Pub Date : 2024-10-09 DOI:10.1007/s00240-024-01645-5

Shuangning Liu, Yu Dai, Fan Jiang, Yatao Jia

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引用次数: 0

Abstract

The correlation between novel negative pressure ureteroscopic lithotripsy (NP-URL) combined with flexible ureteroscopy (FU) and percutaneous nephrolithotomy (PCNL) on stone-free rates (SFR) remains unclear. There is a lack of evidence from Chinese populations regarding the relationship between SFR and NP-URL combined with FU (NP-URL-FU) versus PCNL. We aimed to assess the association between NP-URL-FU and PCNL on SFR. We conducted a cohort study involving 166 participants with 2-4 cm kidney stones. Data on SFR (7 days and 2 months) were collected from all participants. Logistic regression analysis was used to substantiate the research objectives. NP-URL-FU versus PCNL showed an 86% decrease in the 7-day SFR (OR = 0.14, 95% CI 0.07-0.29). The results remained stable even after adjusting for potential confounders. However, no statistically significant association was found between the surgical method and the 2-month SFR. Further exploratory subgroup analyses showed no significant interactions, with all P values > 0.05. Among patients with 2-4 cm kidney stones, NP-URL-FU was associated with a lower risk of incident 7-day SFR than PCNL. However, no statistically significant difference was found in the long-term stone removal rate. Therefore, NP-URL-FU may be a viable alternative surgical option for patients seeking minimally invasive procedures.

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新型负压输尿管镜碎石术联合柔性输尿管镜检查与经皮肾镜碎石术对无结石率的影响：对临床实践和政策的意义。

新型负压输尿管镜碎石术（NP-URL）联合柔性输尿管镜检查（FU）和经皮肾镜碎石术（PCNL）对无结石率（SFR）的影响仍不明确。在中国人群中，关于无结石率（SFR）与 NP-URL 联合 FU（NP-URL-FU）与 PCNL 之间的关系还缺乏证据。我们旨在评估 NP-URL-FU 和 PCNL 对 SFR 的影响。我们进行了一项队列研究，共有 166 名 2-4 厘米肾结石患者参与。我们收集了所有参与者的 SFR 数据（7 天和 2 个月）。我们使用逻辑回归分析来证实研究目标。NP-URL-FU 与 PCNL 相比，7 天的 SFR 降低了 86%（OR = 0.14，95% CI 0.07-0.29）。即使调整了潜在的混杂因素，结果仍保持稳定。然而，手术方法与 2 个月的 SFR 之间并没有统计学意义上的关联。进一步的探索性亚组分析显示，所有P值均大于0.05，无明显的交互作用。在 2-4 厘米肾结石患者中，NP-URL-FU 的 7 天 SFR 发生风险低于 PCNL。然而，在长期结石清除率方面却没有发现有统计学意义的差异。因此，对于寻求微创手术的患者来说，NP-URL-FU可能是一种可行的替代手术方案。

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来源期刊

Urolithiasis UROLOGY & NEPHROLOGY-

CiteScore

4.50

自引率

6.50%

发文量

期刊介绍： Official Journal of the International Urolithiasis Society The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field. Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.