Analysis of clinical results of tubeless-minimally invasive percutaneous nephrolithotripsy with local anesthesia

doi:10.3877/cma.j.issn.1674-3253.2022.03.010

Abstract

Abstract:

Objective

To compare the clinical results of partially tubeless minimally invasive nephrolithotripsy (PCNL) and common MPCNL under local anesthesia, and to explore the safety and clinical efficacy of tubeless MPCNL under local anesthesia.

Methods

From January 2019 to November 2019, 68 patients who underwent PCNL with local anesthesia and 68 patients who underwent MPCNL with local anesthesia and 67 patients who underwent MPCNL with local anesthesia were retrospectively analyzed. The general data of the patients in the two groups were compared.

Results

The clinical data of the two groups were comparable. The average postoperative hospital stay was 3.15 d and 6.48 d in the non-tubular group (P<0.01); the VAS score at 6 h after operation was 4 h and 6.24 h in the tubular group (P<0.01); the VAS score at 1 day after operation was 2.50 and 3.84 in the tubular group (P<0.01); there was no significant difference in the operation time, puncture site, postoperative hemoglobin decrease rate, VAS score on the day of discharge, postoperative fever and stone clearance rate between the two groups (P>0.05).

Conclusion

PCNL under local anesthesia is simple, safe and effective, which is worthy of clinical application. Uncanalized MPCNL for the treatment of renal calculi can reduce postoperative pain and discomfort and shorten hospital stay.

Key words: Kidney stones, Local anesthesia, Tubeless, MPCNL

Xiaofeng Zhao, Ming Liu, Yuanwen Jiang, Jingyi Lu, Binjie Su, Xiao Chen. Analysis of clinical results of tubeless-minimally invasive percutaneous nephrolithotripsy with local anesthesia[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(03): 235-238.

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References 19

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组别	例数	年龄[岁，(±s)]	性别(例)		BMI(kg/m²)	结石大小[mm²，(±s)]	结石位置(例)				肾盂积水宽度[mm，(±s)]
组别	例数	年龄[岁，(±s)]	男	女	BMI(kg/m²)	结石大小[mm²，(±s)]	上盏	中盏	肾盂	下盏	肾盂积水宽度[mm，(±s)]
无管化组	68	39±10	46	22	23.51±3.48	653±209	10	11	32	15	16.3±6.6
有管化组	67	38±80	41	26	22.99±3.16	649±233	9	13	29	16	15.4±6.0
统计值		t=0.623	χ²=0.613		t=0.901	t=0.239	χ²=1.315				t=0.813
P值		0.118	0.475		0.204	0.239	0.352				0.341

组别	例数	年龄[岁，(±s)]	性别(例)		BMI(kg/m²)	结石大小[mm²，(±s)]	结石位置(例)				肾盂积水宽度[mm，(±s)]
组别	例数	年龄[岁，(±s)]	男	女	BMI(kg/m²)	结石大小[mm²，(±s)]	上盏	中盏	肾盂	下盏	肾盂积水宽度[mm，(±s)]
无管化组	68	39±10	46	22	23.51±3.48	653±209	10	11	32	15	16.3±6.6
有管化组	67	38±80	41	26	22.99±3.16	649±233	9	13	29	16	15.4±6.0
统计值		t=0.623	χ²=0.613		t=0.901	t=0.239	χ²=1.315				t=0.813
P值		0.118	0.475		0.204	0.239	0.352				0.341

组别	手术时间[min，(±s)]	住院天数[d，(±s)]	穿刺位置(例)		血红蛋白下降[g/dL，(±s)]	术后VAS评分(±s)			镇痛药物使用(例)	发热(例)
组别	手术时间[min，(±s)]	住院天数[d，(±s)]	第12肋下	第11肋间	血红蛋白下降[g/dL，(±s)]	术后6 h	术后第1天	出院当天	镇痛药物使用(例)	发热(例)
无管化组	70±15	3.15±1.42	38	30	1.87±0.94	4.07±1.79	2.50±1.76	0.91±0.84	2	4
有管化组	72±17	6.48±1.88	32	35	1.57±0.90	6.24±1.33	3.83±2.22	1.15±0.93	6	3
统计值	t=0.055	t=8.148	χ²=0.892		t=1.913	t=7.976	t=3.879	t=1.560	χ²=2.190	χ²=0.135
P值	0.055	0.004	0.391		0.479	0.035	0.034	0.211	0.165	0.713

组别	手术时间[min，(±s)]	住院天数[d，(±s)]	穿刺位置(例)		血红蛋白下降[g/dL，(±s)]	术后VAS评分(±s)			镇痛药物使用(例)	发热(例)
组别	手术时间[min，(±s)]	住院天数[d，(±s)]	第12肋下	第11肋间	血红蛋白下降[g/dL，(±s)]	术后6 h	术后第1天	出院当天	镇痛药物使用(例)	发热(例)
无管化组	70±15	3.15±1.42	38	30	1.87±0.94	4.07±1.79	2.50±1.76	0.91±0.84	2	4
有管化组	72±17	6.48±1.88	32	35	1.57±0.90	6.24±1.33	3.83±2.22	1.15±0.93	6	3
统计值	t=0.055	t=8.148	χ²=0.892		t=1.913	t=7.976	t=3.879	t=1.560	χ²=2.190	χ²=0.135
P值	0.055	0.004	0.391		0.479	0.035	0.034	0.211	0.165	0.713

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