無管迷你經皮腎臟碎石術與逆行性軟式輸尿管鏡腎臟碎石術治療2~3公分上泌尿道結石的比較

李亞哲、周詠欽、鄭明進、沈正煌、林昌德

嘉義基督教醫院 外科部 泌尿科

Comparison between Tubeless Mini-Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for the treatment of 2 to 3cm renal lithiasis   

Ya-Che Lee, Yeong-Chin Jou, Ming-Chin Cheng, Cheng-Huang Shen, Chang-Te Lin

Divisions of Urology, Department of Surgery, Chiayi Christian Hospital

Purpose:

To compare miniaturized percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) in the management of renal stones 2~3 cm at a single medical unit.

Materials and Methods:

Between July 2017 and June 2020, a total of 140 patients underwent tubeless mini-PCNL and RIRS for renal stone size between 2 to 3cm were enrolled in this study. Patient and stone characteristics, perioperative outcomes, and complications were compared between the 2 groups. Statistical analysis used: SPSS version 16.

Results:

Stone-free rates after the procedure were achieved in 78.4% of patients for the tubeless mini-PCNL and 36.4% of patients for the RIRS group (P < 0.001). The mean operative time per patient was 88.6 ± 27.4 minutes in the tubeless mini-PCNL group, and it was 129.1 ± 44.8 minutes in the RIRS groups (P < 0.001). The average hospital stay is 3.4 ± 2.0 days in the tubeless mini-PCNL group and 1.9 ± 1.8 days in the RIRS group (P < 0.001). The postoperative infection rates for the tubeless mini-PCNL and RIRS groups were 9.5% and 6.1%, respectively (P = 0.456). Blood transfusions were needed in one patient in the tubeless mini-PCNL group.

Conclusions:

Tubeless mini-PCNL and RIRS are safe and feasible surgical options to manage renal stones between 2 to 3cm. Tubeless mini-PCNL produced a higher stone-free rate compared with RIRS, but with longer hospital stay and higher postoperative infection rates .