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Abstract：
BACKGROUND: It is possible that this condition will lead to urosepsis and progressive deterioration of renal function in the absence of surgical intervention. Several recent clinical studies have shown that multi-tract percutaneous nephrolithotomy (M-PCNL) has a similar stone free rate (SFR) as standard percutaneous nephrolithotomy (S-PCNL). As a result, M-PCNL was also recommended as a treatment option for staghorn calculi.
OBJECTIVE: To examine the perioperative and long-term results of ultrasonography-guided single- and M-PCNL.
METHODS: This was a retrospective cohort study. Between March 2021 and January 2022, the urology department of our hospital selected patients for the treatment of staghorn calculi using percutaneous nephrolithotomy. The primary outcomes were complication rate and SFR, and the characteristics of patients, operative parameters, laboratory measurements were also collected.
RESULTS: In total, 345 patients were enrolled in the study (186 in the S-PCNL group and 159 in the M-PCNL group). The SFR in the M-PCNL group was significantly higher than that in the S-PCNL group (P = 0.033). Moreover, the incidence rates of hydrothorax (P = 0.03) and postoperative infection (P = 0.012) were higher in the M-PCNL group than in the S-PCNL group. Logistic regression analysis demonstrated that post-operative white blood cell count (OR = 2.57, 95%CI: 1.90-3.47, P < 0.001) and stone size (OR = 1.59, 95%CI: 1.27-2.00, P < 0.001) were associated with a higher overall complication rate in the S-PCNL group. Body mass index (OR = 1.22, 95%CI: 1.06-1.40, P = 0.004) and stone size (OR = 1.70, 95%CI: 1.35-2.15, P < 0.001) were associated with increased overall complications in the M-PCNL group.
CONCLUSIONS: Multiple access tracts can facilitate higher SFR while slightly increasing the incidence of acceptable complications.
OBJECTIVE: To examine the perioperative and long-term results of ultrasonography-guided single- and M-PCNL.
METHODS: This was a retrospective cohort study. Between March 2021 and January 2022, the urology department of our hospital selected patients for the treatment of staghorn calculi using percutaneous nephrolithotomy. The primary outcomes were complication rate and SFR, and the characteristics of patients, operative parameters, laboratory measurements were also collected.
RESULTS: In total, 345 patients were enrolled in the study (186 in the S-PCNL group and 159 in the M-PCNL group). The SFR in the M-PCNL group was significantly higher than that in the S-PCNL group (P = 0.033). Moreover, the incidence rates of hydrothorax (P = 0.03) and postoperative infection (P = 0.012) were higher in the M-PCNL group than in the S-PCNL group. Logistic regression analysis demonstrated that post-operative white blood cell count (OR = 2.57, 95%CI: 1.90-3.47, P < 0.001) and stone size (OR = 1.59, 95%CI: 1.27-2.00, P < 0.001) were associated with a higher overall complication rate in the S-PCNL group. Body mass index (OR = 1.22, 95%CI: 1.06-1.40, P = 0.004) and stone size (OR = 1.70, 95%CI: 1.35-2.15, P < 0.001) were associated with increased overall complications in the M-PCNL group.
CONCLUSIONS: Multiple access tracts can facilitate higher SFR while slightly increasing the incidence of acceptable complications.
摘要：
背景：在没有手术干预的情况下，这种情况可能会导致尿脓毒症和肾功能的进行性恶化。最近的一些临床研究表明，多道经皮肾镜取石术（M-PCNL）与标准经皮肾镜取石术（S-PCNL）具有相似的结石发生率（SFR）。因此,M-PCNL也被推荐作为鹿角形结石的治疗选择。
目的：检查超声引导下的单和M-PCNL的围手术期和长期结果。
方法：这是一项回顾性队列研究。2021年3月至2022年1月，我院泌尿外科选取患者采用经皮肾镜取石术治疗鹿角形结石。主要结果是并发症发生率和SFR，以及患者的特点，操作参数,还收集了实验室测量结果。
结果：总计，345名患者纳入研究（S-PCNL组186名，M-PCNL组159名）。M-PCNL组SFR显著高于S-PCNL组(P=0.033)。此外，M-PCNL组胸水(P=0.03)和术后感染(P=0.012)的发生率高于S-PCNL组.Logistic回归分析显示,S-PCNL组术后白细胞计数(OR=2.57,95CI:1.90~3.47,P<0.001)和结石大小(OR=1.59,95CI:1.27~2.00,P<0.001)与总并发症发生率较高有关。体重指数（OR=1.22，95CI：1.06-1.40，P=0.004）和结石大小（OR=1.70，95CI：1.35-2.15，P<0.001）与M-PCNL组总体并发症增加相关。
结论：多个通道可以促进更高的SFR，同时略微增加可接受的并发症的发生率。
目的：检查超声引导下的单和M-PCNL的围手术期和长期结果。
方法：这是一项回顾性队列研究。2021年3月至2022年1月，我院泌尿外科选取患者采用经皮肾镜取石术治疗鹿角形结石。主要结果是并发症发生率和SFR，以及患者的特点，操作参数,还收集了实验室测量结果。
结果：总计，345名患者纳入研究（S-PCNL组186名，M-PCNL组159名）。M-PCNL组SFR显著高于S-PCNL组(P=0.033)。此外，M-PCNL组胸水(P=0.03)和术后感染(P=0.012)的发生率高于S-PCNL组.Logistic回归分析显示,S-PCNL组术后白细胞计数(OR=2.57,95CI:1.90~3.47,P<0.001)和结石大小(OR=1.59,95CI:1.27~2.00,P<0.001)与总并发症发生率较高有关。体重指数（OR=1.22，95CI：1.06-1.40，P=0.004）和结石大小（OR=1.70，95CI：1.35-2.15，P<0.001）与M-PCNL组总体并发症增加相关。
结论：多个通道可以促进更高的SFR，同时略微增加可接受的并发症的发生率。
