Comparison of intrarenal pelvic pressure during F24 channel and F16 channel for percutaneous nephrolithotomy
10.3760/cma.j.issn.1000-6702.2016.05.009
- VernacularTitle:F24通道和F16通道经皮肾镜取石术中肾盂内压的对比研究
- Author:
Zhigang ZHONG
;
Tiejun PAN
;
Gongcheng LI
- Publication Type:Journal Article
- Keywords:
Percutaneous nephrolithotomy;
Channel;
Intrarenal pelvic pressure;
Prospective studies
- From:
Chinese Journal of Urology
2016;37(5):354-357
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the size of access channel that may influence the intrarenal pelvic pressure during percutaneous nephrolithotomy.Methods From April 2014 to July 2015,83 patiens with unilateral renal calculus,ranged from 20 to 40mam were divided into 2 group randomly.40 cases underwent F24 channel PCNL and 43 cases underwent F16 channel PCNL.There was no statistically significant difference between the groups in preoperative variables,such as age,gender,preoperative status of infection,status of hydrpnephrosis,size and location of stone (P > 0.05).We used a 6Fr ureteral catheter positioned into the renal pelvic,and the intrarenal pelvic pressure was measured by anesthesia monitor IBP channel during PCNL in different stages (entrance into the collecting system,calculi fragmentation,and termination)for all patients.Removing calculus time,postoperative hemoglobin changing,fever rate,procalcitonin abnormal rate,white blood cell counts and calculi clearance rate were recorded and compared.Results The intrarenal pelvic pressure in different stages on F24 channel and F16 channel were (7.5 ± 1.3)、(22.5± 4.3)、(14.0 ± 2.7) mmHg and (10.3 ± 1.1)、(34.6 ± 4.1)、(23.0 ± 3.6) mmHg,respectively.There was statistically significant difference between 2 groups (P < 0.05).Compared with F16 channel,F24 channel had significant differences in removing calculus time [(12.8 ± 3.7) min vs.(23.3 ± 3.6) min],fever rate [17.5% (7/40) vs.39.5% (17/43)],procalcitonin abnormal rate [15.0% (6/40) vs.34.9%(15/43)] and white blood cell counts abnormal rate [10.0% (4/40) vs.27.9% (12/43)] (P < 0.05).However,no significant difference in postoperative hemoglobin changing [(11.8 ± 4.4)g/L vs.(13.7 ±4.7)g/L] and calculi clearance rate [87.5% (35/40) vs.81.4% (35/43)] (P >0.05).Conclusions Compared with F16 channel,the F24 channel PCNL maintains lower renal pelvic pressure,which is less than reflux limit,during calculi fragmentation,It might be contributed to reduce the postoperative fever rate.It can short time for removing calculi and achieve the better effect.