SO SÁNH HIỆU QUẢ CỦA PHẪU THUẬT LẤY SỎI THẬN QUA DA ĐƯỜNG HẦM NHỎ VỚI ĐƯỜNG HẦM TIÊU CHUẨN ĐIỀU TRỊ SỎI THẬN ĐƠN GIẢN

Abstract

Objectives: To compare the efficacy of mini with standard percutaneous nephrolithotomy (PCNL) for the treatment of single kidney stones. Patients and Methods: The data of consecutive adult patients who underwent PCNL for the treatment of kidney stones, between December 2016 and December 2022 were retrospectively reviewed. All cases were performed in a prone position under fluoroscopic guidance. The nephrostomy tracts were dilatated to 26 Fr in standard-PCNL and to 16,6 Fr in mini-PCNL. A nephrostomy tube was inserted after PCNL. Study design: prospective cohort with comparison group. Results: The study included 178 patients; 89 underwent sPCNL and 89 underwent mPCNL. The stone-free rates after 3 months of PCNL monotherapy were comparable for both groups (91,01% for mPCNL and 94,38% for sPCNL, p > 0,05). The incidence (17,96% vs 24,27%, p = 0.048) and severity of complications were significantly lesser with mPCNL (p = 0.031). The operation times and complication transfusion rates did not different between two groups. Hospital stay and VAS (Visual Analogue Scale) was significantly longer for sPCNL than mPCNL (median stay of 3,17 vs 4,31 days, p < 0.001). Conclusions: The efficacy of mPCNL was comparable to sPCNL in the treatment of single kidney stones. The advantages of mPCNL included reduced pain and shorter hospital stay.