PDF(Pubmed)
Abstract：
UNASSIGNED: Supine percutaneous nephrolithotomy (s-PCNL) offers great benefits from urological and anaesthetic points of view. We present the first evaluation of the outcomes of s-PCNL in Malaysia. Our aim was to explore the safety and efficacy of s-PCNL.
UNASSIGNED: Institutional review board approval was obtained from the National Medical Research Register (NMRR ID-21002225-WLP). We retrospectively reviewed 115 patients with renal pelvis stones who underwent single renal access during s-PCNL between November 2020 and May 2023. Patients who underwent simultaneous ipsilateral or contralateral endourological procedures were included. The data were analysed to determine stone-free rates (SFR), major complication rates, blood transfusion rates, operative times and lengths of hospital stay (LOS).
UNASSIGNED: The SFR was higher for the single middle calyceal renal access (MCA) group than for the lower calyceal renal access (LCA) or upper calyceal renal access (UCA) groups (OR: 1.76; 95% confidence interval [CI]: 0.63, 4.92). In total, 0, 1 and 2 patients had major complications in the UCA, MCA and LCA groups, respectively (P = 0.453). One of the 115 patients (0.9%) needed blood transfusion. Subgroup analysis revealed mean operative times of 76.3 min and 78.6 min for patients who underwent sole s-PCNL (PCNL-only group) and those who had simultaneous ipsilateral and contralateral endourological procedures (PCNL-plus group), respectively (P = 0.786). The overall mean LOS was 2.9 days.
UNASSIGNED: s-PCNL is a safe and effective alternative treatment for renal stones. We would recommend s-PCNL for patients who require an ipsilateral/contralateral endourological procedure (URS/RIRS) because it is time-efficient. All renal accesses are safe. Single MCA is recommended for complete stone clearance.
UNASSIGNED: Institutional review board approval was obtained from the National Medical Research Register (NMRR ID-21002225-WLP). We retrospectively reviewed 115 patients with renal pelvis stones who underwent single renal access during s-PCNL between November 2020 and May 2023. Patients who underwent simultaneous ipsilateral or contralateral endourological procedures were included. The data were analysed to determine stone-free rates (SFR), major complication rates, blood transfusion rates, operative times and lengths of hospital stay (LOS).
UNASSIGNED: The SFR was higher for the single middle calyceal renal access (MCA) group than for the lower calyceal renal access (LCA) or upper calyceal renal access (UCA) groups (OR: 1.76; 95% confidence interval [CI]: 0.63, 4.92). In total, 0, 1 and 2 patients had major complications in the UCA, MCA and LCA groups, respectively (P = 0.453). One of the 115 patients (0.9%) needed blood transfusion. Subgroup analysis revealed mean operative times of 76.3 min and 78.6 min for patients who underwent sole s-PCNL (PCNL-only group) and those who had simultaneous ipsilateral and contralateral endourological procedures (PCNL-plus group), respectively (P = 0.786). The overall mean LOS was 2.9 days.
UNASSIGNED: s-PCNL is a safe and effective alternative treatment for renal stones. We would recommend s-PCNL for patients who require an ipsilateral/contralateral endourological procedure (URS/RIRS) because it is time-efficient. All renal accesses are safe. Single MCA is recommended for complete stone clearance.
摘要：
■仰卧位经皮肾镜取石术（s-PCNL）从泌尿外科和麻醉的角度提供了巨大的好处。我们对马来西亚s-PCNL的结果进行了首次评估。我们的目的是探讨s-PCNL的安全性和有效性。
■机构审查委员会批准从国家医学研究注册（NMRRID-21002225-WLP）获得。我们回顾性分析了在2020年11月至2023年5月期间在s-PCNL期间接受单肾通路的115例肾盂结石患者。包括同时接受同侧或对侧腔内手术的患者。分析数据以确定无结石率(SFR)，主要并发症发生率,输血率,手术时间和住院时间（LOS）。
■单中肾小管肾通路（MCA）组的SFR高于下肾小管肾通路（LCA）或上肾小管肾通路（UCA）组（OR：1.76；95％置信区间[CI]：0.63，4.92）。总的来说,0、1和2例患者在UCA中有主要并发症，MCA和LCA组，分别为(P=0.453)。115例患者中有1例（0.9%）需要输血。亚组分析显示，接受单独s-PCNL（仅PCNL组）和同时进行同侧和对侧腔内手术（PCNL-plus组）的患者的平均手术时间为76.3分钟和78.6分钟，分别为(P=0.786)。总平均LOS为2.9天。
■s-PCNL是一种安全有效的肾结石替代治疗方法。对于需要同侧/对侧腔内手术（URS/RIRS）的患者，我们建议使用s-PCNL，因为它具有时效性。所有肾脏通路都是安全的。建议使用单个MCA进行完整的石材清除。
■机构审查委员会批准从国家医学研究注册（NMRRID-21002225-WLP）获得。我们回顾性分析了在2020年11月至2023年5月期间在s-PCNL期间接受单肾通路的115例肾盂结石患者。包括同时接受同侧或对侧腔内手术的患者。分析数据以确定无结石率(SFR)，主要并发症发生率,输血率,手术时间和住院时间（LOS）。
■单中肾小管肾通路（MCA）组的SFR高于下肾小管肾通路（LCA）或上肾小管肾通路（UCA）组（OR：1.76；95％置信区间[CI]：0.63，4.92）。总的来说,0、1和2例患者在UCA中有主要并发症，MCA和LCA组，分别为(P=0.453)。115例患者中有1例（0.9%）需要输血。亚组分析显示，接受单独s-PCNL（仅PCNL组）和同时进行同侧和对侧腔内手术（PCNL-plus组）的患者的平均手术时间为76.3分钟和78.6分钟，分别为(P=0.786)。总平均LOS为2.9天。
■s-PCNL是一种安全有效的肾结石替代治疗方法。对于需要同侧/对侧腔内手术（URS/RIRS）的患者，我们建议使用s-PCNL，因为它具有时效性。所有肾脏通路都是安全的。建议使用单个MCA进行完整的石材清除。
