Negative pressure suction sheath for minimally invasive percutaneous nephrolithotomy in oblique supine position

doi:10.3877/cma.j.issn.1674-3253.2019.04.010

Abstract

Abstract:

Objective

To investigate the safety and clinical efficacy of negative pressure aspiration sheath combined with minimally invasive percutaneous nephrolithotomy (MPCNL) in oblique supine position for complex renal calculi.

Methods

440 patients with renal calculus in our hospital from January 2017 to December 2018 were randomly divided into two groups: observation group and control group, 220 cases in each group. Patients in the observation group underwent MPCNL with negative pressure suction sheath in oblique supine position, while the control group in conventional prone position with single hole sheath (atmospheric sheath). Operation time, stone removal rate, bleeding volume and complications of each group were recorded. The clinical data of the two groups were retrospectively analyzed and compared.

Results

Stone removal rate was higher in observation group (P<0.05), while operation time, intraoperative bleeding volume, incidence of serious complications, incidence of fever, PCT value and CRP value of one day after operation in the observation group were significantly less than those in the control group (P<0.05).

Conclusion

MPCNL with negative pressure sheath in oblique supine pospine has fewer complications and higher stone removal rate, and oblique supine position does not need to change position for transurethral retrograde ureteral intubation.

Key words: Renal calculi, Percutaneous nephrolithotomy, Oblique supine position, negative, pressure aspiration sheath

Ming Xi, Qiuping Zheng, Wei Hua, Song Wan, Wencong Jiang, Yuanlin Liu, Guangpeng Deng, Zhaochang Zeng, Yulin Zhou. Negative pressure suction sheath for minimally invasive percutaneous nephrolithotomy in oblique supine position[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(04): 255-258.

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References 14

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组别	例数	性别（例）		年龄（岁，±s）	侧别（例）		BMI（kg/m²，±s）	结石长径（mm，±s）	结石合并感染性（例）
组别	例数	男	女	年龄（岁，±s）	左侧	右侧	BMI（kg/m²，±s）	结石长径（mm，±s）	结石合并感染性（例）
观察组	220	152	68	40±16	109	111	26±6	43±10	23
对照组	220	149	71	44±20	117	103	24±4	42±9	32
统计值	?	χ²=0.086		t=0.435	χ²=0.151		t=-0.363	t=-0.382	0.755
P值	?	0.885		0.902	0.702		0.298	0.962	0.368

组别	例数	性别（例）		年龄（岁，±s）	侧别（例）		BMI（kg/m²，±s）	结石长径（mm，±s）	结石合并感染性（例）
组别	例数	男	女	年龄（岁，±s）	左侧	右侧	BMI（kg/m²，±s）	结石长径（mm，±s）	结石合并感染性（例）
观察组	220	152	68	40±16	109	111	26±6	43±10	23
对照组	220	149	71	44±20	117	103	24±4	42±9	32
统计值	?	χ²=0.086		t=0.435	χ²=0.151		t=-0.363	t=-0.382	0.755
P值	?	0.885		0.902	0.702		0.298	0.962	0.368

组别	例数	结石取尽率	术后严重并发症	术后发热
A组	220	211（95.9）	0（0）	31（14.1）
B组	220	189（85.9）	7（3.2）	72（32.7）
χ²值	?	13.997	-	10.259
P值	?	0.006	0.015	0.008

组别	例数	结石取尽率	术后严重并发症	术后发热
A组	220	211（95.9）	0（0）	31（14.1）
B组	220	189（85.9）	7（3.2）	72（32.7）
χ²值	?	13.997	-	10.259
P值	?	0.006	0.015	0.008

组别	例数	手术时间（min）	术中出血（ml）	术后1 d PCT值（μg/L）	术后1 d CRP值（mg/L）
A组	220	67±10	76±18	0.7±0.3	28±20
B组	220	100±19	160±33	4.4±2.0	66±23
t值	?	4.010	20.358	2.997	3.963
P值	?	0.005	0.001	0.008	0.006

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