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小於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
Tubeless Mini-Percutaneous nephrolithotomy versus retrograde intrarenal surgery for upper urinary stones of ≤ 3cm
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 ≤ 3 cm at a single medical unit.

Materials and Methods: Between October 2017 and September 2018, a total of 239 patients underwent tubeless mini-PCNL and RIRS for renal stone size ≤ 3 cm 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 81.8% of patients for the tubeless mini-PCNL and 65.2% of patients for the RIRS group (P = 0.019). The mean operative time per patient was 84.27 ± 27.6 minutes in the tubeless mini-PCNL group, and it was 89.54 ± 41.4 minutes in the RIRS groups (P = 0.276). The average hospital stay is 2.54 ± 1.93 days in the tubeless mini-PCNL group and 2.84 ± 1.13 days in the RIRS group (P = 0.375). The postoperative infection rates for the tubeless mini-PCNL and RIRS groups were 10.6% and 1.9%, respectively (P < 0.05). 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 ≤ 3 cm. Tubeless mini-PCNL produced a higher stone-free rate compared with RIRS, but with higher postoperative infection rates.