同軸金屬擴張與雙極電燒刀應用在經皮造廔截石術之回溯性臨床結果比較:單一醫院經驗
唐靖、羅華安、陳國強、謝德生、林志明、王世鋒
1國泰綜合醫院 外科部 泌尿科; 2輔仁大學醫學系
Retrospective comparison between coaxial metal dilatation and plasma vaporization for tract creation in percutaneous nephrolithotomy: a single center experience
Chin Tang1, Wah-On Lo1, Kuo-Chiang Chen1, Teh-Sheng Hsieh1, Chih-Ming Lin1, Shih-Feng Wang1,2
1Division of Urology, Department of Surgery, Cathay General Hospital, Taipei, Taiwan
2School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
Purpose: To compare the clinical outcome and safety between application of coaxial metal dilation and plasma vaporization in percutaneous nephrolithotomy (PCNL).
Materials and Methods: We retrospectively reviewed the records of patients who underwent successful PCNL at our institute from 2013/01 to 2018/01, with a total of 135 patients included. 72 patients underwent plasma vaporization, whereas 63 patients received coaxial metal dilatation for tract creation. Patient’s general characteristics, stone locations, surgical outcomes, operation time, hospital stay, and time of nephrostomy tube removal were compared between the two groups.
Results: There was no statistically significant difference in patients’ general characteristics. Furthermore, they did not differ significantly in terms of intraoperative blood loss, operation time, stone free rate, hospital stay, and time of nephrostomy tube removal. However, post-operative blood transfusion rate was significantly lower in the plasma vaporization group (20% vs. 3.17%, p=0.01).
Conclusion: In our study, plasma vaporization for tract creation in percutaneous nephrolithotomy is as good as coaxial metal dilation in terms of stone free rate and surgical outcome, with the advantage of decreasing the need for post-operative blood transfusion.