Comparison of single-port percutaneous nephroscopy and laparoscopy in the treatment of renal cysts

doi:10.3877/cma.j.issn.1674-3253.2024.06.006

Abstract

Abstract:

Objective

To evaluate the safety and efficacy of single-port percutaneous nephroscopic unroofing of renal cysts and traditional laparoscopic unroofing of renal cysts.

Methods

The clinical data of patients with renal cyst from January 2019 to December 2021 were analyzed retrospectively. Single-port percutaneous nephroscopic unroofing of renal cysts was performed in 14 cases and laparoscopic unroofing in 39 cases. There was no significant difference in gender，age，BMI between the two groups （P＞0.05），as well as the size and position of cysts （P＞0.05）. The treatment-related endpoints of the two groups were compared，including hospital stay，operation time，intraoperative blood loss，postoperative drainage，postoperative length of stay and postoperative painkiller use. In addition，the adverse effect and follow-up of the two groups were evaluated.

Results

The operations of 53 patients in both groups were completed successfully. The hospital stay in single-port group was less than those in the laparoscopy group，but there was no significant difference between the two groups ［（4.1±1.4） d vs （5.9±2.0） d，P=0.056］. No significant differences were found between the two groups in operation time ［80.5（36.0） min vs 63.0（37.0） min］，intraoperative blood loss ［7.5（8.0） ml vs 10.0（0.0） ml］，postoperative drainage ［0.0（50.0） ml vs 0.0（30.0） ml］ and painkiller use ［2.0（2.0）vs 1.0（4.0） times］. The postoperative length of stay in single-port group was significantly shorter than that in laparoscopy group ［（2.4±0.5） d and （3.1±0.8） d，P=0.002］. There were no obvious adverse reactions in the single-port group，but 2 cases in the laparoscopy group. Twelve cases in single-port group and 17 cases in laparoscopy group were followed up，and the imaging examination of 29 cases showed complete disappearance or more than 50% volume reduction of renal cysts，no recurrence cases in both groups.

Conclusions

The effect of single-port percutaneous nephroscopic unroofing of renal cyst is similar to that of laparoscopic renal cyst unroofing，which is safe and feasible，and it has a certain advantage in postoperative length of stay.

Key words: Percutaneous nephrolithotomy, Laparoscope, Renal cyst

Bin Cao, Qiang Wang, Yangbai Lu, Hongxing Huang, Yaqiang Huang, Yongfu Long, Rui Zhong, Canyong Li, Gang Luo. Comparison of single-port percutaneous nephroscopy and laparoscopy in the treatment of renal cysts[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(06): 566-571.

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Figures/Tables 4

组别	例数	性别（例）		年龄［岁，（ $\bar{x}$ ±s）］	BMI［kg/m²，（ $\bar{x}$ ±s）］	囊肿大小［mm，（ $\bar{x}$ ±s）］		囊肿位置（例）
组别	例数	男	女	年龄［岁，（ $\bar{x}$ ±s）］	BMI［kg/m²，（ $\bar{x}$ ±s）］	囊肿横径	囊肿纵径	左侧	右侧	背侧	腹侧	上极	中极	下极
单孔经皮肾镜组	14	8	6	57±11	22.7±3.2	66±14	60±13	9	5	7	7	6	6	2
腹腔镜组	39	17	22	57±13	24.1±2.9	61±16	54±13	19	20	13	26	16	15	8
统计值		χ²=0.759		t=0.081	t=-1.475	t=1.143	t=1.397	χ²=1.002		χ²=1.218		χ²=0.270
P值		0.384		0.936	0.146	0.258	0.168	0.317		0.270		0.874

组别	例数	性别（例）		年龄［岁，（ $\bar{x}$ ±s）］	BMI［kg/m²，（ $\bar{x}$ ±s）］	囊肿大小［mm，（ $\bar{x}$ ±s）］		囊肿位置（例）
组别	例数	男	女	年龄［岁，（ $\bar{x}$ ±s）］	BMI［kg/m²，（ $\bar{x}$ ±s）］	囊肿横径	囊肿纵径	左侧	右侧	背侧	腹侧	上极	中极	下极
单孔经皮肾镜组	14	8	6	57±11	22.7±3.2	66±14	60±13	9	5	7	7	6	6	2
腹腔镜组	39	17	22	57±13	24.1±2.9	61±16	54±13	19	20	13	26	16	15	8
统计值		χ²=0.759		t=0.081	t=-1.475	t=1.143	t=1.397	χ²=1.002		χ²=1.218		χ²=0.270
P值		0.384		0.936	0.146	0.258	0.168	0.317		0.270		0.874

组别	例数	住院天数［d，（ $\bar{x}$ ±s）］	手术时间［min，M（Q）］	出血量［ml，M（Q）］	引流量［ml，M（Q）］	术后住院天数［d，（ $\bar{x}$ ±s）］	止痛药使用次数［次，M（Q）］	不良反应（例）
单孔经皮肾镜组	14	4.1±1.4	80.5（36.0）	7.5（8.0）	0.0（50.0）	2.4±0.5	2.0（2.0）	0
腹腔镜组	39	5.9±2.0	63.0（37.0）	10.0（0.0）	0.0（30.0）	3.1±0.8	1.0（4.0）	2
统计值		t=-1.959	Z=-2.190	Z=-1.346	Z=-0.024	t=-3.250	Z=-1.039	χ²=0.002
P值		0.056	0.280	0.181	0.986	0.002	0.306	0.963

组别	例数	住院天数［d，（ $\bar{x}$ ±s）］	手术时间［min，M（Q）］	出血量［ml，M（Q）］	引流量［ml，M（Q）］	术后住院天数［d，（ $\bar{x}$ ±s）］	止痛药使用次数［次，M（Q）］	不良反应（例）
单孔经皮肾镜组	14	4.1±1.4	80.5（36.0）	7.5（8.0）	0.0（50.0）	2.4±0.5	2.0（2.0）	0
腹腔镜组	39	5.9±2.0	63.0（37.0）	10.0（0.0）	0.0（30.0）	3.1±0.8	1.0（4.0）	2
统计值		t=-1.959	Z=-2.190	Z=-1.346	Z=-0.024	t=-3.250	Z=-1.039	χ²=0.002
P值		0.056	0.280	0.181	0.986	0.002	0.306	0.963

组别	例数	随访（例）	随访时间［月，M（Q）］	完全消失（例）	体积减少＞50%（例）	剩余体积［%，M（Q）］
单孔经皮肾镜组	14	12	1.0（3.0）	7	5	2.23（4.39）
腹腔镜组	39	17	3.0（8.0）	9	8	5.29（9.35）
统计值		χ²=7.378	Z=-1.115	-	-	Z=-1.025
P值		0.007	0.274	＞0.999	＞0.999	0.354

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