Volume 22 Issue 10
Oct.  2024
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(10): 1679-1683
LIU Jun, HE Wei, LOU Yanting, LU Zhaoxiang, SHI Dong, TANG Yurui. Safety and feasibility of partial tubeless percutaneous nephrolithotripsy[J]. Chinese Journal of General Practice, 2024, 22(10): 1679-1683. doi: 10.16766/j.cnki.issn.1674-4152.003710
Citation: LIU Jun, HE Wei, LOU Yanting, LU Zhaoxiang, SHI Dong, TANG Yurui. Safety and feasibility of partial tubeless percutaneous nephrolithotripsy[J]. Chinese Journal of General Practice, 2024, 22(10): 1679-1683. doi: 10.16766/j.cnki.issn.1674-4152.003710
shu

Safety and feasibility of partial tubeless percutaneous nephrolithotripsy

doi: 10.16766/j.cnki.issn.1674-4152.003710

  • Department of Urology, the Chaohu Hospital of Anhui Medical University, Hefei, Anhui 238000, China

Funds:

 KJ2021A0335

  • Received Date: 2024-02-05
    Available Online: 2024-12-28
    Abstract
  •   Objective   To investigate the safety and clinical efficacy of partial tubeless percutaneous nephrolithotripsy(PCNL).   Methods   A total of 87 patients with renal ureteral stones admitted to the Chaohu Hospital of Anhui Medical University between January 2021 to June 2023 were divided into 47 cases in the traditional percutaneous nephrolithotomy (with indwelling nephrostomy tube and double J-tube) surgical group and 40 cases in the percutaneous nephrolithotomy partially untubed (with indwelling double J-tube only) surgical group according to surgical methods. All 87 surgical procedures were performed by the same surgical team. The data pertaining to the preoperative and perioperative periods, along with the factors that may potentially influence the incidence factors that may potentially influence the incidence of complications associated with percutaneous nephrolithotomy were comparable between the two groups.   Results   In the traditional percutaneous nephroscopic surgery group, the postoperative hospitalization duration [7.00 (6.00, 9.00) d vs. 5.00 (4.00, 6.00) d], first time out of bed [4.00 (3.00, 5.00) d vs. 2.00 (2.00, 3.00) d], incidence of postoperative complications [17 cases (36.2%) vs. 3 cases (7.5%)] and postoperative VAS score [7.00 (7.00, 8.00) vs. 5.00 (5.00, 5.00)] were significantly different from those in the percutaneous nephroscopic partial tubeless surgery group (P < 0.05). With the exception of gender, the two groups exhibited statistically significant differences in preoperative age, BMI and STONE score. Preoperative urinary leukocytes, comorbidities of diabetes mellitus, hypertension, and cardiac disease did not reach statistical significance (P>0.05). A multifactorial analysis revealed that STONE score and surgical approach were independent risk factors for postoperative complications.   Conclusion   Percutaneous nephrolithotomy for partial tubelessness offers significant advantages in terms of surgical safety, postoperative VAS score, postoperative recovery time, average hospital stay, treatment cost, and treatment efficiency. It is therefore a procedure that merits further promotion.

     

    • FullText(HTML)
  • loading
    • References(23)
  • [1]
    ABDRABUH A M I, GHANEM M M A, YAHIA M A A, et al. Reliability and validity of "S.T.O.N. E" nephrolithometry scoring system to predict the stone-free rate after percutaneous nephrolithotomy[J]. Urol Ann, 2021, 13(1): 14-18.
    [2]
    DESAI J, SHAH H N. Mini percutaneous kidney stone removal: applicable technologies[J]. Urol Clin North Am, 2022, 49(1): 161-173. doi: 10.1016/j.ucl.2021.08.003
    [3]
    MAZZON G, CHOONG S, CELIA A. Stone-scoring systems for predicting complications in percutaneous nephrolithotomy: a systematic review of the literature[J]. Asian J Urol, 2023, 10(3): 226-238. doi: 10.1016/j.ajur.2023.01.005
    [4]
    彭剑, 郭文彬, 陈韬亦, 等. 腔内超声造影与常规超声引导经皮肾镜取石术治疗肾结石的Meta分析[J]. 中国内镜杂志, 2023, 29(4): 27-36.

    PENG J, GUO W B, CHEN T Y, et al. Meta-analysis of intracavitary contrast-enhanced ultrasound and conventional ultrasound-guided percutaneous nephrolithotomy in the treatment of kidney stones[J]. Chinese Journal of Endoscopy, 2023, 29(4): 27-36.
    [5]
    张斌, 王翔. 超声与X线引导下经皮肾镜取石术治疗儿童复杂性肾结石的疗效及安全性比较[J]. 临床小儿外科杂志, 2020, 19(8): 683-687. doi: 10.3969/j.issn.1671-6353.2020.08.005

    ZHANG B, WANG X. Comparison of the efficacy and safety of ultrasound and X-ray guided percutaneous nephrolithotomy in the treatment of complicated kidney stones in children[J]. Journal of Clinical Pediatric Surgery, 2020, 19(8): 683-687. doi: 10.3969/j.issn.1671-6353.2020.08.005
    [6]
    张国银, 姜彦飞, 潘良朋, 等. 微创经皮肾镜碎石术与电子输尿管软镜术治疗肾结石的疗效对比研究[J]. 医药论坛杂志, 2022, 43(19): 45-48.

    ZHANG G Y, JIANG Y F, PAN L P, et al. Comparative study on the efficacy of minimally invasive percutaneous nephrolithotripsy and electronic ureteroscopy in the treatment of kidney stones[J]. Journal of Medical Forum, 2022, 43(19): 45-48.
    [7]
    尹雪艳, 朱景香, 吴晓梦, 等. 输尿管软镜与经皮肾镜碎石术治疗肾结石疗效及对MDA和Cor水平的影响[J]. 医药论坛杂志, 2023, 44(18): 71-74.

    YIN X Y, ZHU J X, WU X M, et al. Effect of flexible ureteroscopy and percutaneous nephrolithotripsy in the treatment of renal calculi and its effect on MDA and Cor levels[J]. Journal of Medical Forum, 2023, 44(18): 71-74.
    [8]
    黄裕棱, 李卓航, 刘成, 等. 斜跨位多通道经皮肾镜碎石术与单通道经皮肾镜联合输尿管软镜碎石术治疗鹿角形肾结石的疗效对比[J]. 中华医学杂志, 2021, 101(38): 3121-3126.

    HUANG Y L, Li Z H, LIU C, et al. Comparative effect of oblique translocation multi-channel percutaneous nephrolithotripsy and single channel percutaneous nephrolithotripsy combined with flexible ureteroscopy in the treatment of staghorn kidney stones[J]. Chinese Journal of Medicine, 2021, 101(38): 3121-3126.
    [9]
    宋明泽, 唐寅. 经皮肾镜碎石取石术与经尿道输尿管软镜碎石取石术治疗肾结石的临床疗效对比[J]. 中华全科医学, 2021, 19(5): 753-755, 766. doi: 10.16766/j.cnki.issn.1674-4152.001908

    SONG M Z, TANG Y. Comparison of clinical efficacy of percutaneous nephrolithotomy and transurethral flexible ureteral lithotomy in the treatment of kidney stones[J]. Chinese Journal of General Practice, 2021, 19(5): 753-755, 766. doi: 10.16766/j.cnki.issn.1674-4152.001908
    [10]
    包鹏飞, 叶俊杰, 张会江. 超声引导经"肾椎体乳头-盏颈"穿刺在经皮肾镜碎石取石术中的安全性研究[J]. 浙江创伤外科, 2023, 28(10): 1807-1810.

    BAO P F, YE J J, ZHANG H J. Study on the safety of ultrasound-guided percutaneous nephrolithotomy through "renal vertebrae papillary-calyceal neck"[J]. Zhejiang Trauma Surgery, 2023, 28(10): 1807-1810.
    [11]
    戚宇诚, 林方优, 李柏均, 等. 基于肾脏血管解剖建立经皮肾通道的临床研究[J]. 临床泌尿外科杂志, 2023, 38(1): 10-14.

    QI Y C, LIN F Y, LI B J, et al. Clinical study on the establishment of percutaneous renal channel based on renal vascular anatomy[J]. Journal of Clinical Urology, 2023, 38(1): 10-14.
    [12]
    饶婷, 阮远, 程帆. 超声引导下经"肾盏穹隆-盏颈轴线"两步穿刺法: PCNL通道建立的解剖学研究及临床应用[J]. 现代泌尿外科杂志, 2021, 26(3): 185-188.

    RAO T, RUAN Y, CHENG F. Ultrasound guided two-step puncture through "calyceal dome-calyceal neck axis" : Anatomical study and clinical application of PCNL channel establishment[J]. Journal of Modern Urology, 2021, 26(3): 185-188.
    [13]
    孙涛, 李良成, 王图超, 等. 经尿道输尿管软镜碎石术与经皮肾镜碎石术治疗肾结石的比较研究[J]. 贵州医药, 2022, 46(9): 1453-1455.

    SUN T, LI L C, WANG T C, et al. Comparative study of transurethral flexible ureteral lithotripsy and percutaneous nephrolithotripsy in the treatment of kidney stones[J]. Guizhou Medicine, 2022, 46(9): 1453-1455.
    [14]
    许凯豪, 宋梦瑶, 焦德超, 等. Histoacryl组织胶超选择性栓塞肾动脉分支治疗医源性肾动脉出血[J]. 中国介入影像与治疗学, 2022, 19(8): 449-453.

    XU K H, SONG M Y, JIAO D C, et al. Treatment of iatrogenic renal artery hemorrhage by hyperselective embolization with Histoacryl adhesive[J]. Chinese Journal of Interventional Imaging and Therapeutics, 2022, 19(8): 449-453.
    [15]
    窦全亮, 周六化, 李荣飞, 等. 直视下双导丝扩张法: 一种建立经皮肾通道的新方式[J]. 现代泌尿外科杂志, 2023, 28(11): 980-983.

    DOU Q L, ZHOU L H, LI R F, et al. Double guide wire dilation under direct vision: a new approach to establish percutaneous renal channel[J]. Journal of Modern Urology, 2023, 28(11): 980-983.
    [16]
    张英晨, 赵帅, 孙浩, 等. 局麻下非同步CT辅助联合超声定位微创经皮肾镜取石术治疗上尿路结石的效果[J]. 山东大学学报(医学版), 2023, 61(10): 46-50, 57.

    ZHANG Y C, ZHAO S, SUN H, et al. Effect of non-synchronous CT assisted minimally invasive percutaneous nephrolithotomy under local anesthesia in the treatment of upper urinary tract stones[J]. Journal of Shandong University (Medical Science Edition), 2023, 61(10): 46-50, 57.
    [17]
    黄锐, 陈新华. 基于CT, 三维重建技术的不同穿刺路径对经皮肾穿刺肾上盏的安全性研究[J]. 泌尿外科杂志(电子版), 2022, 14(1): 22-25.

    HUANG R, CHEN X H. Study on the safety of percutaneous renal puncture of upper calicae by different puncture paths based on CT+ 3D reconstruction[J]. Journal of Urology, 2022, 14(1): 22-25.
    [18]
    陈忠华, 林志根, 彭士彬, 等. 部分无管化与留置肾造瘘管经皮肾镜碎石术治疗上尿路结石患者的效果比较[J]. 中国民康医学, 2021, 33(22): 154-155, 158.

    CHEN Z H, LIN Z G, PENG S B et al. Comparison of the effect of percutaneous nephrolithotripsy with partial tubeless and indwelling nephrostomy in the treatment of upper urinary tract stones[J]. Chinese Journal of Medical Sciences, 2021, 33(22): 154-155, 158.
    [19]
    黄旭锋, 杨水法, 洪德时, 等. 对比分析部分无管化与留置肾造瘘管经皮肾镜碎石术治疗上尿路结石的临床效果[J]. 中外医疗, 2023, 42(19): 96-99.

    HUANG X F, YANG S F, HONG D S et al. To compare and analyze the clinical effect of percutaneous nephrolithotripsy with partial catheterization and indwelling nephrostomy in the treatment of upper urinary tract stones[J]. Chinese and foreign medical treatment, 2023, 42(19): 96-99.
    [20]
    何祥彪, 刘杨洋, 杜丹, 等. 部分无管化与标准经皮肾镜取石术治疗上尿路结石的有效性及安全性[J]. 现代泌尿外科杂志, 2023, 28(6): 516-518, 528.

    HE X B, LIU Y Y, DU D, et al. Efficacy and safety of partial tubeless and standard percutaneous nephrolithotomy in the treatment of upper urinary tract stones[J]. Journal of Modern Urology, 2023, 28(6): 516-518, 528.
    [21]
    周剑芳, 高诚, 阳东荣. S.T.O.N.E. 评分与肾结石经皮肾镜术后清石率及并发症的相关性分析[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2020, 15(2): 121-125.

    ZHOU J F, GAO C, YANG D R. Correlation analysis of S.T.O.N.E. score with stone removal rate and complications after percutaneous nephroscopy[J/CD]. Chinese Journal of Endoscopic Urology, 2020, 15(2): 121-125.
    [22]
    KARANI R, ARADA R B, OKHUNOV Z, et al. Endoscopic guided percutaneous nephrolithotomy[J]. J Endourol, 2021, 35(S2): S62-S67.
    [23]
    DIBIANCO J M, GHANI K R. Precision stone surgery: current status of miniaturized percutaneous nephrolithotomy[J]. Curr Urol Rep, 2021, 22(4): 24. DOI: 10.1007/s11934-021-01042-0.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(4)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (37) PDF downloads(2) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return