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Needle-perc-assisted endoscopic surgery (NAES) for patients with complicated solitary kidney stones: a prospective randomized study from a single center

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Abstract

Purpose

The goal of this study is to compare traditional percutaneous nephrolithotomy (PCNL) and needle-perc-assisted endoscopic surgery (NAES) in the treatment of complicated solitary kidney stones via a single-center randomized controlled prospective study.

Methods

A total of patients with complex (Guy’s score II–IV) solitary kidney stones between July 2019 to June 2022 were enrolled in the study. Participants were stratified into two groups: needle-perc-assisted endoscopic surgery group (group A) and traditional PCNL group (group B). All procedures were finished by X-ray free technique. The clinical characteristics and outcomes were analyzed.

Results

A total of 90 (44 in Group A and 46 in Group B) patients were finally included in our study. There were no statistically differences in terms of gender, age, body mass index (BMI), stone burden between two groups. The mean operative duration of Group A was significant higher than group B (95.1 ± 21.4 min vs 72.5 ± 29.5 min, p=0.02). The 1-month stone-free rate (SFR) was significant higher in Group A than B (90.9% vs 73.9%, p=0.03). A less hemoglobin drop (p=0.01), shorter postoperative in-hospital day (p=0.04), and lower severe complication (Clavien–Dindo III and above) rates (p=0.03) were observed in Group A.

Conclusion

For patients with solitary kidney stones, NAES technique provides a higher one-session SFR, a better renal function recovery and compared with traditional PCNL.

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Data availability

All data generated or analyzed during this study were included in this. Further enquiries can be directed to the corresponding author.

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Funding

Supported by Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding, code: XMLX202118.

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Author notes

  1. Xue Zeng and Xiaolin Diao contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Urology, Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital, Tsinghua University Clinical Institute, No.168, Litang Road, Changping District, Beijing, 102218, China

    Xue Zeng, Song Jin, Weiguo Hu, Wenjie Bai, Jianxing Li & Bo Xiao

  2. Department of Medicine, Peking University Hospital, Beijing, 100871, China

    Xiaolin Diao

Authors
  1. Xue Zeng
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  2. Xiaolin Diao
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  3. Song Jin
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  4. Weiguo Hu
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  5. Wenjie Bai
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  6. Jianxing Li
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  7. Bo Xiao
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Contributions

XZ: was involved in data analysis, manuscript writing. XD: was involved in data analysis, manuscript writing. SJ: contributed to data collection. WH: contributed to data collection. WB: contributed to data collection. Jianxing Li helped in project development. Bo Xiao helped in project development.

Corresponding author

Correspondence to Bo Xiao.

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Conflict of interest

All authors declared that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The clinical trial was registered at Beijing Tsinghua Changgung Hospital (approved by Beijing Tsinghua Changgung Hospital Medical Ethic Committee No. 21025–0-01).

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Zeng, X., Diao, X., Jin, S. et al. Needle-perc-assisted endoscopic surgery (NAES) for patients with complicated solitary kidney stones: a prospective randomized study from a single center. World J Urol 41, 3121–3127 (2023). https://doi.org/10.1007/s00345-023-04576-9

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  • DOI: https://doi.org/10.1007/s00345-023-04576-9

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