目的:本研究旨在比较逆行肾内手术(RIRS)和微型经皮肾镜取石术(mini-PCNL)治疗小儿1-2cm肾结石的结果。
方法:回顾性分析2008年2月至2022年4月首次诊断为单侧1-2cm肾结石并接受内镜手术的18岁以下患者的记录。将患者分为两组:微型PCNL和RIRS手术。参数,如年龄,性别,石头的数量,侧面,检查了尺寸和本地化。研究的主要终点是比较两次手术后一个月的无结石率(SFR)。手术和透视次数,术后住院时间,比较两组患者血红蛋白下降和并发症发生率。术后1个月通过直接泌尿系统造影和USG或CT评估SFR。
结果:共58例患者纳入研究。微型PCNL组35例,RIRS组23例。表1显示了两组的人口统计学和临床特征。各组之间在年龄方面没有显著差异,性别,石头尺寸,location,侧面和密度。两组草酸钙结石的发生率均较高。微型PCNL组的平均透视时间较高(p=0.001)。微型PCNL组的平均手术时间较低(p=0.024)。经皮组的平均血红蛋白下降更大(p=0.039)。两组在术后住院时间方面没有差异,并发症发生率,手术后一个月和SFR。
结论:尽管与RIRS相比,mini-PCNL在手术时间方面似乎更有利,在平均透视时间方面是不利的,接受辐射和平均血红蛋白减少。
OBJECTIVE: This study aimed to compare the results of retrograde intrarenal surgery (RIRS) and mini-percutaneous nephrolithotomy (mini-PCNL) for the treatment of 1-2 cm kidney stones in pediatric patients.
METHODS: The records of patients under the age of 18 years who were diagnosed with unilateral 1-2 cm kidney stones for the first time and underwent endoscopic surgery between February 2008 and April 2022 were retrospectively examined. The patients were divided into two groups: mini-PCNL and RIRS surgery. Parameters such as age, gender, number of stones, side, size and localization were examined. The main endpoint of the study was to compare stone-free rates (SFR) one month after both surgeries. Surgery and fluoroscopy times, postoperative hospital stay, hemoglobin decrease and complication rates were compared between the groups. SFR was evaluated one month after surgery by direct urinary system radiography and USG or CT.
RESULTS: A total of 58 patients were included in the study. There were 35 patients in the mini-PCNL group and 23 patients in the RIRS group. Table 1 shows the demographic and clinical characteristics of both groups. There was no significant difference between the groups in terms of age, gender, stone size, location, side and density. Calcium oxalate stones were observed at a higher rate in both groups. Mean fluoroscopy time was higher in the mini-PCNL group (p = 0.001). The mean surgery time was lower in the mini-PCNL group (p = 0.024). The mean hemoglobin decrease was greater in the percutaneous group (p = 0.039). There were no differences between the groups in terms of postoperative hospital stay, complication rates, and SFR one month after surgery.
CONCLUSIONS: Although mini-PCNL seems to be more advantageous in terms of operation time compared to RIRS, it is disadvantageous in terms of average fluoroscopy time, radiation received and average hemoglobin decrease.