科研之友
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摘要
OBJECTIVE To compare the safety and efficacy of minimally invasive percutaneous nephrolitholapaxy (MIP) between small (%26lt;2 cm) and large (%26gt;2 cm) renal calculi, because although MIP has proved its efficacy in small lower caliceal stones, the efficacy in large renal calculi has been questioned. %26lt;br%26gt;MATERIALS AND METHODS The data from 191 consecutive minimally invasive percutaneous nephrolithotomy (MIP) procedures at a single institution from January 2007 to March 2011 were reviewed retrospectively. All stone sizes and complexity were included (98 were %26lt;2 cm and 93 were %26gt;= 2 cm). We performed a comparative analysis of procedures for calculi %26lt;2 cm and %26gt;= 2 cm regarding the stone-free rate, the need for auxiliary procedures, and complications. The Student t test for parametric continuous variables and the chi-square test or Fischer%26apos;s exact test for nominal variables were applied. %26lt;br%26gt;RESULTS The primary stone-free rate was significantly lower for the large than for the small stones (76.3% vs 90.8%, P = .007), and the secondary stone-free rate after one auxiliary procedure (second-look percutaneous nephrolithotomy, ureterorenoscopy, or shock wave lithotripsy) was not significantly different between the 2 groups (94.6% vs 98.9%, P = .1). The total complication rate was not significantly different (26.9% vs 19.4%, P = .2) between the 2 groups either. Grade III complications occurred in 5.2% of all patients, and no grade IV or V complications were observed. %26lt;br%26gt;CONCLUSION Using MIP, the total stone-free rate was greater for the small than for the large calculi; however, most patients could be rendered stone-free with the use of one auxiliary procedure. The high success rate and low rate of higher grade complications justify the application of MIP for large stones. UROLOGY 81: 241-245, 2013.
- 出版日期2013-2
