Applications of flexible ureteroscope lithotripsy with negative pressure suction and percutaneous nephrolithotomy in the treatment of 2-3 cm diameter renal calculi.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY

Clinical and Experimental Nephrology Pub Date : 2024-11-14 DOI:10.1007/s10157-024-02588-2

Juan Qi, Dawei Ni, Jiamin Shen

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引用次数: 0

Abstract

Background: Renal calculus, or kidney stone disease, presents a significant healthcare challenge globally, necessitating diverse therapeutic interventions. Percutaneous nephrolithotomy (PCNL) and flexible ureteroscope lithotripsy (FURL) are prominent among these interventions, with PCNL favored for stones > 2 cm and FURL for smaller stones and applications of flexible ureteroscope lithotripsy with negative pressure suction for stones 1.5-2.5 cm have some benefit.

Methods: From June 2019 to January 2024, 310 patients undergoing FURL with negative pressure suction or PCNL for 2-3 cm renal calculi were retrospectively analyzed. The demographic and clinical data were collected, and outcomes including stone-free rates (SFR), postoperative complications, and surgical parameters were compared.

Results: Comparable SFR were observed between FURL and PCNL groups at 1-month follow-up, although PCNL was superior to FURL after immediately post-surgery. FURL exhibited significantly fewer complications overall (5.7% vs. 19.3%, p = 0.044), shorter hospital stays, and lower postoperative pain levels. The surgical parameters favored FURL, showing lower bleeding volumes, shorter catheter removal times, and less hemoglobin decrease postoperatively.

Conclusion: Despite similar stone clearance efficacy at 1-month follow-up, FURL demonstrated superior safety and postoperative outcomes compared to PCNL for 2-3 cm renal calculi. These findings highlight the potential advantages of FURL in reducing complications, enhancing recovery, and optimizing patient care pathways.

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应用输尿管软镜碎石负压吸引术和经皮肾镜碎石术治疗直径 2-3 厘米的肾结石。

背景：肾结石或肾石症是全球面临的重大医疗挑战，需要采取多种治疗干预措施。经皮肾镜取石术（PCNL）和柔性输尿管镜碎石术（FURL）是这些干预措施中的佼佼者，PCNL适用于大于2厘米的结石，FURL适用于较小的结石，而应用负压吸引柔性输尿管镜碎石术治疗1.5-2.5厘米的结石有一定的疗效：方法：回顾性分析2019年6月至2024年1月期间，310例因2-3厘米肾结石接受FURL负压吸引或PCNL治疗的患者。收集了人口统计学和临床数据，并比较了无结石率（SFR）、术后并发症和手术参数等结果：结果：随访 1 个月时，FURL 组和 PCNL 组的无结石率相当，但 PCNL 术后即刻无结石率优于 FURL。FURL 的总体并发症明显更少（5.7% 对 19.3%，P = 0.044），住院时间更短，术后疼痛程度更低。手术参数显示，FURL的出血量更少，导管拔出时间更短，术后血红蛋白下降更少：结论：尽管在1个月的随访中结石清除效果相似，但对于2-3厘米的肾结石，FURL的安全性和术后效果优于PCNL。这些发现凸显了 FURL 在减少并发症、促进康复和优化患者护理路径方面的潜在优势。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.