■我们的目标是回顾冲击波碎石术(SWL)的结果,输尿管镜检查,和经皮肾镜碎石术(PCNL)治疗脊髓神经病(SNP)患者的肾和输尿管结石。
■于2023年3月8日使用PubMed进行了文献检索,EMBASE,和谷歌学者没有日期限制。临床前/动物研究,reviews,给编辑的信,病例报告,会议摘要被排除在外。只有英文论文被接受。
■接受了35篇文章。五项研究集中在SWL上,17在PCNL上,和6在输尿管镜检查。其余条款采用了不止一个程序。石头成分已从鸟粪石转变为更常见的磷酸钙。SWL显示出非常差的无结石率(SFR),可能是由于患者定位的挑战,石头可视化,本地化,无法自发传递碎片。输尿管软镜和PCNL与感染并发症的高发生率相关。长期住院,输血率高,和重症监护入院。也有死亡案例。由于泌尿生殖系统的重建,这两个程序都具有挑战性,脊柱侧凸和后凸,肋骨畸形,下肢挛缩,和严重的合并症也影响了麻醉。SFR低于非神经系统患者。
■SWL,输尿管碎石术,由于定位问题,PCNL应被认为是SNP中具有挑战性的程序,术中和围手术期发病率的风险增加,甚至死亡率。应建议使用计算机断层扫描来评估残留片段,因为必须尽量减少对SNP的再干预,而SNP应最好在转诊中心进行治疗。
UNASSIGNED: We aim to review the outcomes of shock wave lithotripsy (SWL), ureteroscopy, and percutaneous nephrolithotripsy (PCNL) for renal and ureteral stones in spinal cord neuropathy patients (SNP).
UNASSIGNED: A literature search was performed on 8th March 2023 using PubMed, EMBASE, and Google Scholar with no date limit. Preclinical/animal studies, reviews, letters to the editor, case reports, and meeting abstracts were excluded. Only English papers were accepted.
UNASSIGNED: Thirty-five articles were accepted. Five studies focused on SWL, 17 on PCNL, and 6 on ureteroscopy. The remaining articles employed more than one procedure. Stone composition has shifted from struvite to the more common calcium phosphate. SWL showed a very poor stone-free rate (SFR) likely due to challenges in patient positioning, stone visualization, localization, and inability to pass fragments spontaneously. Flexible ureteroscopy and PCNL were associated with a high incidence of infectious complications, long hospital stays, high blood transfusion rate, and intensive care admissions. There were also cases of death. Both procedures were challenging due to genitourinary reconstruction, scoliosis and kyphosis, rib-cage deformity, lower limb contractures, and severe comorbidity which also affected anesthesia. SFR was lower than in non-neurological patients.
UNASSIGNED: SWL, ureterolithotripsy, and PCNL should be considered challenging procedures in SNP due to positioning issues, an increased risk of intra and peri-operative morbidity, and even mortality. Computed tomography should be recommended to assess residual fragments as it becomes imperative to minimize a re-intervention in SNP who should be preferably treated in referral centers.