Archivos espanoles de urologia · 2026
Efficacy of Retrograde Intrarenal Surgery Combined with Super-Mini Percutaneous Nephrolithotomy versus that of Microchannel Percutaneous Nephrolithotomy in the Treatment of Complex Renal Stones.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Wang Qingsong, Tang Yongyong
Аннотация
BACKGROUND: This study aimed to compare the efficacy of retrograde intrarenal surgery (RIRS) combined with super-mini percutaneous nephrolithotomy (SMP) versus microchannel percutaneous nephrolithotomy (MPCNL) for complex renal stones (CRSs) and identify prognostic factors.
METHODS: A retrospective analysis was conducted on 156 patients with CRS (January 2022-January 2025), divided into the RIRS + SMP group (n = 85) and MPCNL group (n = 71). Perioperative indicators, inflammatory stress, renal function, postoperative pain and complications were compared. A 60-day follow-up categorised prognosis into poor (n = 23) and normal (n = 133) groups, with logistic regression analysing poor prognosis factors.
RESULTS: The RIRS + SMP group had a longer operative time but significantly less intraoperative blood loss, shorter postoperative hospital stay and earlier ambulation (p < 0.05) than the MPCNL group. Stone-free rates were comparable and showed no significant difference (p > 0.05). At 3 days postoperatively, inflammatory markers (procalcitonin (PCT), high-sensitivity Creactive protein (hs-CRP), cortisol (Cor) and malondialdehyde (MDA)) and renal function indicators (blood urea nitrogen (BUN), urinary creatinine (UCr) and cystatin C (Cys-C)) were lower in the RIRS + SMP group (p < 0.05) than in the MPCNL group. Visual Analog Scale (VAS) scores were consistently lower at 6, 12, 24 and 48 h postoperatively (p < 0.05), with a reduced overall complication rate (p < 0.05). Multivariate logistic regression identified surgical approach, diabetes mellitus and indwelling catheterisation time as independent poor prognosis risk factors (p < 0.05).
CONCLUSIONS: For CRS, SMP combined with RIRS provides comparable stone clearance rates with superior recovery and fewer complications than MPCNL, whereas diabetes and catheter duration warrant attention as prognostic factors.
METHODS: A retrospective analysis was conducted on 156 patients with CRS (January 2022-January 2025), divided into the RIRS + SMP group (n = 85) and MPCNL group (n = 71). Perioperative indicators, inflammatory stress, renal function, postoperative pain and complications were compared. A 60-day follow-up categorised prognosis into poor (n = 23) and normal (n = 133) groups, with logistic regression analysing poor prognosis factors.
RESULTS: The RIRS + SMP group had a longer operative time but significantly less intraoperative blood loss, shorter postoperative hospital stay and earlier ambulation (p < 0.05) than the MPCNL group. Stone-free rates were comparable and showed no significant difference (p > 0.05). At 3 days postoperatively, inflammatory markers (procalcitonin (PCT), high-sensitivity Creactive protein (hs-CRP), cortisol (Cor) and malondialdehyde (MDA)) and renal function indicators (blood urea nitrogen (BUN), urinary creatinine (UCr) and cystatin C (Cys-C)) were lower in the RIRS + SMP group (p < 0.05) than in the MPCNL group. Visual Analog Scale (VAS) scores were consistently lower at 6, 12, 24 and 48 h postoperatively (p < 0.05), with a reduced overall complication rate (p < 0.05). Multivariate logistic regression identified surgical approach, diabetes mellitus and indwelling catheterisation time as independent poor prognosis risk factors (p < 0.05).
CONCLUSIONS: For CRS, SMP combined with RIRS provides comparable stone clearance rates with superior recovery and fewer complications than MPCNL, whereas diabetes and catheter duration warrant attention as prognostic factors.