PDF(Pubmed)
Abstract：
UNASSIGNED: The objectives of this work are to compare the outcomes between loach guidewire and super-stiff guidewire during percutaneous nephrolithotomy (PCNL) and find potential indications of different guidewires.
UNASSIGNED: We retrospectively reviewed our institutional PCNL database from 2017 to 2021. Patients who underwent PCNL guided by loach guidewire were assigned to group A (489 patients); patients who received super-stiff guidewire were assigned to group B (269 patients). Preoperative demographic data, intraoperative parameters, and postoperative complications were compared. The conditions and reasons of failed placement of guidewire needed readjustment were evaluated as well.
UNASSIGNED: Preoperative demographic data and most intraoperative parameters were not statistically different between the groups. Postoperative Clavien-Dindo complications were also comparable, with low rate of complications. However, failed placement of guidewire more occurred in group A (8.2% vs. 4.0%, respectively, p = 0.03). Compared with the super-stiff guidewire, the loach guidewire was easier pass/slip into any place either it be perinephric or blood vessels. In most failed group A cases and all failed group B cases, the guidewire was placed in the perirenal fat. Six patients (15%) in group A, the guidewires entered into vessels.
UNASSIGNED: Our results support that the faulty placement of loach guidewire is significantly more common compared with super-stiff guidewire. Double confirmation is needed to prevent a major complication out of wrong dilatation whenever there is doubt about the wrong location of the guidewire.
UNASSIGNED: We retrospectively reviewed our institutional PCNL database from 2017 to 2021. Patients who underwent PCNL guided by loach guidewire were assigned to group A (489 patients); patients who received super-stiff guidewire were assigned to group B (269 patients). Preoperative demographic data, intraoperative parameters, and postoperative complications were compared. The conditions and reasons of failed placement of guidewire needed readjustment were evaluated as well.
UNASSIGNED: Preoperative demographic data and most intraoperative parameters were not statistically different between the groups. Postoperative Clavien-Dindo complications were also comparable, with low rate of complications. However, failed placement of guidewire more occurred in group A (8.2% vs. 4.0%, respectively, p = 0.03). Compared with the super-stiff guidewire, the loach guidewire was easier pass/slip into any place either it be perinephric or blood vessels. In most failed group A cases and all failed group B cases, the guidewire was placed in the perirenal fat. Six patients (15%) in group A, the guidewires entered into vessels.
UNASSIGNED: Our results support that the faulty placement of loach guidewire is significantly more common compared with super-stiff guidewire. Double confirmation is needed to prevent a major complication out of wrong dilatation whenever there is doubt about the wrong location of the guidewire.
摘要：
■这项工作的目的是比较经皮肾镜取石术（PCNL）中泥法导丝和超硬导丝之间的结果，并找到不同导丝的潜在适应症。
■我们回顾性审查了2017年至2021年的机构PCNL数据库。接受泥法导丝引导的PCNL患者被分配到A组（489例患者）；接受超硬导丝的患者被分配到B组（269例患者）。术前人口统计学数据,术中参数,并对术后并发症进行比较。还评估了需要重新调整的导丝放置失败的条件和原因。
■术前人口统计学数据和大多数术中参数在组间没有统计学差异。术后Clavien-Dindo并发症也相当，并发症发生率低。然而,A组导丝放置失败更多(8.2%vs.4.0%，分别,p=0.03)。与超硬导丝相比，泥炭导丝更容易通过/滑入肾周或血管的任何位置。在大多数失败的A组和所有失败的B组中，导丝放置在肾周脂肪中.A组6名患者（15%），导丝进入血管。
■我们的结果支持，与超硬导丝相比，泥法泥导丝的错误放置明显更常见。每当对导丝的错误位置有疑问时，都需要双重确认以防止由于错误扩张而引起的重大并发症。
■我们回顾性审查了2017年至2021年的机构PCNL数据库。接受泥法导丝引导的PCNL患者被分配到A组（489例患者）；接受超硬导丝的患者被分配到B组（269例患者）。术前人口统计学数据,术中参数,并对术后并发症进行比较。还评估了需要重新调整的导丝放置失败的条件和原因。
■术前人口统计学数据和大多数术中参数在组间没有统计学差异。术后Clavien-Dindo并发症也相当，并发症发生率低。然而,A组导丝放置失败更多(8.2%vs.4.0%，分别,p=0.03)。与超硬导丝相比，泥炭导丝更容易通过/滑入肾周或血管的任何位置。在大多数失败的A组和所有失败的B组中，导丝放置在肾周脂肪中.A组6名患者（15%），导丝进入血管。
■我们的结果支持，与超硬导丝相比，泥法泥导丝的错误放置明显更常见。每当对导丝的错误位置有疑问时，都需要双重确认以防止由于错误扩张而引起的重大并发症。
