评估经皮肾镜取石术治疗鹿角结石的预后及并发症

Q4 Medicine
Mehmet Yilmaz, Gökhan Çil
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引用次数: 0

摘要

背景/目的:泌尿系统结石疾病在一般人群中发生率为1- 20%。有多种手术方法,经皮肾镜取石术(PCNL)是一种常用的治疗方法,特别是对于大的鹿角型肾结石。本研究的目的是比较结石形态图在预测鹿角结石PCNL后的操作参数和复杂参数方面的作用。方法:回顾性分析2017年至2022年间66例接受PCNL的鹿角结石患者。研究人员使用非对比计算机断层扫描对患者的Guy、S.T.O.N.E.和CROSS肾镜取石评分进行了评估。采用Clavien Dindo分类法评价手术并发症。结果:结石负担、GUY、s.t.o.n.e、CROES评分平均为1114.9±520.18 mm²;3.64±0.48;分别为10.11±1.2和142.9±31.99。37.9%的患者达到总无结石状态(SFS),中位结石清除率为93.74(50-100)。GUY评分与SFS之间无统计学意义,而S.T.O.N.E.和CROES评分之间有统计学意义(p分别为0.020和0.004)。ROC分析显示,CROES和S.T.O.N.E.评分系统及结石负荷参数对SFS的估计准确度相近。结果显示,只有S.T.O.N.E.评分与并发症的发生有显著关系(p = 0.034)。结论:如果经皮肾镜取石术治疗鹿角结石是可行的,目前的评分系统不能单独预测术后结果和并发症程度。需要进一步进行大规模的多中心前瞻性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of nephrolithometric scoring systems to predict outcomes and complications of percutaneous nephrolithotomy for staghorn stone
Background/Aim: Urinary system stone disease develops with a frequency of 1-20 % in the general population. There are various surgical methods and percutaneous nephrolithotomy (PCNL) is a commonly used treatment method, especially in large, staghorn kidney stones. Aim of this study was compare stone nomograms in forecasting operative and complicating parameters subsequent to PCNL in staghorn stones. Methods: The study analysed 66 patients with staghorn stones who underwent PCNL between 2017 and 2022, retrospectively. The researcher evaluated the Guy, S.T.O.N.E. and CROSS nephrolithotomy scores in patients using non-contrast computed tomography. The Clavien Dindo Classification was used to evaluate the surgical complication. Results: The mean stone burden, GUY, S.T.O.N.E. and CROES scores were 1114.9 ± 520.18 mm²; 3.64 ± 0.48; 10.11 ± 1.2 and 142.9 ± 31.99, respectively. Total stone-free status (SFS) was achieved in 37.9 % of the patients, while the median stone clearance rate was 93.74 (50-100). While no statistical significance was observed between GUY score and SFS, it was observed in S.T.O.N.E. and CROES scores (p = 0.020 and 0.004, respectively). ROC analysis showed that CROES and S.T.O.N.E. scoring systems and the stone burden parameter showed similar accuracy in the estimation of SFS. The results showed that only the S.T.O.N.E. score showed a significant relationship with the presence of complications (p = 0.034). Conclusion: If the percutaneous nephrolithotomy for staghorn stones in question is, current scoring systems alone couldn't be predictive for postoperative outcomes and degree of complications. Further large scale multicentre prospective studies are needful.
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CiteScore
0.60
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0.00%
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13
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4 weeks
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