Background:The goal of this study was to determine the safety and efficacy of endoscopic combined intrarenal surgery(ECIRS)performed in the prone split-leg position for the treatment of complex renal stones.Materials ...Background:The goal of this study was to determine the safety and efficacy of endoscopic combined intrarenal surgery(ECIRS)performed in the prone split-leg position for the treatment of complex renal stones.Materials and methods:A mature ECIRS protocol was designed.Retrospective analysis was conducted of medical records between January 2020 and December 2021 of patients with complex renal stones at one center who underwent ECIRS by 2 skilled surgeons using retrograde flexible ureteroscopy and mini-percutaneous nephrolithotomy in the prone split-leg position.Results:A total of 44 patients were included in this study.Mean stone size was 26.1±12.7 mm,and the number of calyces involved was 4.36±2.09.Mean operative time was 71.1±21.8 minutes.Postoperative decline in hemoglobin was 15.8±9.8 g/L.Seventy-five percent of patients achieved stone-free status.The mean number of residual stones was 2.8±2.3,and the mean residual stone size was 10.30±4.76 mm.Six patients(13.6%)developed postoperative complications,including 4 with fever during the first 2 days postoperatively and 2 patients with transient postoperative pain.No patients developed severe complications.Conclusions:Endoscopic combined intrarenal surgery in the prone split-leg position can be performed safely by experienced surgeons using retrograde flexible ureteroscopy in conjunction with mini-percutaneous nephrolithotomy as a successful technique for the treatment of complex renal stones.展开更多
目的系统评价分腿俯卧位经皮肾镜取石术(PCNL)的临床效果和安全性,探讨分腿俯卧位的可行性、有效性和优越性。方法计算机检索PubMed、Cochrane Library、Web of Science、CINAHL、Embase、OVID、中国知网、中国生物医学文献数据库、万...目的系统评价分腿俯卧位经皮肾镜取石术(PCNL)的临床效果和安全性,探讨分腿俯卧位的可行性、有效性和优越性。方法计算机检索PubMed、Cochrane Library、Web of Science、CINAHL、Embase、OVID、中国知网、中国生物医学文献数据库、万方数据库、维普数据库中关于分腿俯卧位PCNL的RCT及队列研究,检索时限为建库至2022年8月。按照纳入和排除标准筛选文献,并进行文献质量评价,采用RevMan 5.4软件进行Meta分析。结果Meta分析最终纳入14篇文献,共2477例患者。结果显示,相较于传统俯卧位PCNL,分腿俯卧位PCNL的手术时间[MD=-15.17(-20.47,-9.8),Z=21.23,P<0.01]及住院时间[MD=-1.06(-1.79,-0.32),Z=2.81,P<0.01]短,术中出血量[MD=-15.82(-30.39,-1.26),Z=2.13,P=0.03]及并发症发生率[M-H=0.72(0.57,0.91),Z=2.72,P=0.007]低;相较于斜仰卧位PCNL,分腿俯卧位PCNL所需手术时间短[MD=-23.02(-28.87,-18.17),Z=9.30,P<0.01],但并发症发生率高[M-H=1.78(1.23,2.58),Z=3.07,P=0.002]。而在皮肾通道建立时间[MD=-1.69(-5.58,2.21),Z=0.85,P=0.40]、结石清除率[M-H=1.07(1.00,1.15),Z=1.99,P=0.05]、再手术率[M-H=0.50(0.18,1.36),Z=1.36,P=0.17]方面,暂未发现分腿俯卧位较其他体位差异有统计意义。结论分腿俯卧位PCNL能缩短患者手术时间及住院时间,较传统俯卧位PCNL具有更低的并发症发生率。而在皮肾通道建立时间、结石清除率、再手术率方面与传统俯卧位PCNL相似。展开更多
文摘Background:The goal of this study was to determine the safety and efficacy of endoscopic combined intrarenal surgery(ECIRS)performed in the prone split-leg position for the treatment of complex renal stones.Materials and methods:A mature ECIRS protocol was designed.Retrospective analysis was conducted of medical records between January 2020 and December 2021 of patients with complex renal stones at one center who underwent ECIRS by 2 skilled surgeons using retrograde flexible ureteroscopy and mini-percutaneous nephrolithotomy in the prone split-leg position.Results:A total of 44 patients were included in this study.Mean stone size was 26.1±12.7 mm,and the number of calyces involved was 4.36±2.09.Mean operative time was 71.1±21.8 minutes.Postoperative decline in hemoglobin was 15.8±9.8 g/L.Seventy-five percent of patients achieved stone-free status.The mean number of residual stones was 2.8±2.3,and the mean residual stone size was 10.30±4.76 mm.Six patients(13.6%)developed postoperative complications,including 4 with fever during the first 2 days postoperatively and 2 patients with transient postoperative pain.No patients developed severe complications.Conclusions:Endoscopic combined intrarenal surgery in the prone split-leg position can be performed safely by experienced surgeons using retrograde flexible ureteroscopy in conjunction with mini-percutaneous nephrolithotomy as a successful technique for the treatment of complex renal stones.
文摘目的系统评价分腿俯卧位经皮肾镜取石术(PCNL)的临床效果和安全性,探讨分腿俯卧位的可行性、有效性和优越性。方法计算机检索PubMed、Cochrane Library、Web of Science、CINAHL、Embase、OVID、中国知网、中国生物医学文献数据库、万方数据库、维普数据库中关于分腿俯卧位PCNL的RCT及队列研究,检索时限为建库至2022年8月。按照纳入和排除标准筛选文献,并进行文献质量评价,采用RevMan 5.4软件进行Meta分析。结果Meta分析最终纳入14篇文献,共2477例患者。结果显示,相较于传统俯卧位PCNL,分腿俯卧位PCNL的手术时间[MD=-15.17(-20.47,-9.8),Z=21.23,P<0.01]及住院时间[MD=-1.06(-1.79,-0.32),Z=2.81,P<0.01]短,术中出血量[MD=-15.82(-30.39,-1.26),Z=2.13,P=0.03]及并发症发生率[M-H=0.72(0.57,0.91),Z=2.72,P=0.007]低;相较于斜仰卧位PCNL,分腿俯卧位PCNL所需手术时间短[MD=-23.02(-28.87,-18.17),Z=9.30,P<0.01],但并发症发生率高[M-H=1.78(1.23,2.58),Z=3.07,P=0.002]。而在皮肾通道建立时间[MD=-1.69(-5.58,2.21),Z=0.85,P=0.40]、结石清除率[M-H=1.07(1.00,1.15),Z=1.99,P=0.05]、再手术率[M-H=0.50(0.18,1.36),Z=1.36,P=0.17]方面,暂未发现分腿俯卧位较其他体位差异有统计意义。结论分腿俯卧位PCNL能缩短患者手术时间及住院时间,较传统俯卧位PCNL具有更低的并发症发生率。而在皮肾通道建立时间、结石清除率、再手术率方面与传统俯卧位PCNL相似。
