Evidence map›Paper›PMID 39112963›Full record

ArticleBMC urology2024

Clinical comparison of lateral supine position mini-percutaneous nephrolithotomy and anatrophic nephrolithotomy in the treatment of complete staghorn renal calculi.

Bo Chen, Min Wang, Zongping Chen, Ningrui Pan, Xu He, Bengen Li, Congcong Chen, Zidong Zhou, Wei Cui, Peng Zhang and 2 more

Abstract readComparative Study
In one paragraph

Article in BMC urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Bo Chen *Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Min WangDepartment of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Zongping ChenDepartment of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China. 2404259310@qq.com.
Ningrui PanDepartment of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Xu HeDepartment of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Bengen Li *Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Congcong ChenDepartment of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Zidong Zhou *Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Wei CuiDepartment of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Peng ZhangDepartment of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Qixu Ren *Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Youzhuang Zhong *Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAt present, the guidelines for urology recommend percutaneous nephrolithotomy (PCNL) as the preferred treatment for staghorn renal calculi (SRC). However, for complete SRC, it has been questioned by clinicians and patients due to high residual stone rate, complications, repeated hospitalizations and high treatment cost. Anatrophic nephrolithotomy (ANL) is a traditional and classic method for the treatment of SRC. Due to its high trauma and high technical requirements, it is difficult to carry out in primary hospitals, and gradually replaced by PCNL. The purpose of this study is to compare the efficacy of PCNL and ANL in the treatment of complete SRC.

methodsOverall, 238 patients with complete SRC were divided into mini-PCNL in lateral supine position group, (n = 190) and ANL group (n = 94) according to treatment for a retrospective cohort study. The calculi parameters, renal function index, comorbidities of calculi, surgical complications, length and frequency of hospitalization, treatment costs, results of postoperative satisfaction survey were compared between the two groups.

resultsThe risk of the residual stone rate after mini-PCNL in lateral supine position was 239 times (OR = 238.667, P < 0.0001), the number of residual stone 1.3 times (OR = 1.326, P < 0.0001), the amount of residual stone 2.2 times (OR = 2.224, P < 0.0001) that of ANL. The risk of the cost of initial treatment after mini-PCNL in lateral supine position was 3.3 times (OR = 3.273, P < 0.0001), the total cost of treatment 4 times (OR = 4.051, P < 0.0001), the total length of hospital stays 1.4 times (OR = 1.44, P < 0.0001) that of ANL, the incidence of postoperative renal atrophy was 2.2 times (OR = 2.171, P = 0.008) higher in the ANL than in the mini-PCNL in lateral supine position. Glomerular filtration rate (GFR) reduction after ANL was 1.4 times (OR = 1.381, P = 0.037) greater than that after mini-PCNL in lateral supine position at 24-month follow-up. The risk of the overall satisfaction of ANL was 58 times (OR = 57.857, P < 0.0001) higher than that of mini-PCNL in lateral supine position, the number of branches of staghorn greater than 8 is a high risk factor for the occurrence of residual stone after mini-PCNL in lateral supine position (OR = 353.137, P < 0.0001).

conclusionAlthough the risk of renal atrophy and decreased GFR after ANL is higher than that of mini-PCNL in lateral supine position, the efficacy of traditional ANL in the treatment of complete SRC was generally superior to that of mini-PCNL in lateral supine position. Moreover, number of branches of staghorn greater than 8 are the preferred ANL for complete SRC.

trial registrationChiCTR2100047462. The trial was registered in the Chinese Clinical Trial Registry; registration date: 19/06/2021.

Indexed as

Nephrolithotomy, PercutaneousPatient PositioningStaghorn CalculiAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesSupine PositionTreatment OutcomeAnatrophic nephrolithotomyCurative effect evaluationPercutaneous nephrolithotomyStaghorn renal calculi

Identifiers

PMID39112963
PMCPMC11304705

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