The clinical and cost effectiveness of surgical interventions for stones in the lower pole of the kidney: the percutaneous nephrolithotomy, flexible ureterorenoscopy and extracorporeal shockwave lithotripsy for lower pole kidney stones randomised controlled trial (PUrE RCT) protocol
The clinical and cost effectiveness of surgical interventions for stones in the lower pole of the kidney: the percutaneous nephrolithotomy, flexible ureterorenoscopy and extracorporeal shockwave lithotripsy for lower pole kidney stones randomised controlled trial (PUrE RCT) protocol
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DOI：
10.1186/s13063-020-04326-x
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发表时间：
2020-06-04
期刊：
影响因子：
2.5
通讯作者：
Wiseman, Oliver
中科院分区：
文献类型：
--
作者：
McClinton, Sam;Starr, Kathryn;Wiseman, Oliver
简介 肾结石很常见，成人终生患病率为 10%。由于肥胖和糖尿病的增加，全球发病率正在增加，这些患者群体更有可能患有肾结石疾病。结石引起的胁腹痛（肾绞痛）是英国泌尿科急诊的最常见原因。结石最常见于肾下极（类似于 35% 的病例），如果不进行干预，这里的结石最不可能排出。目前，英国国家卫生服务中心提供三种技术可用于清除下极肾结石：体外冲击波碎石术 (ESWL)、经皮肾镜取石术 (PCNL) 和输尿管软镜碎石术 (FURS) 结合激光碎石术。目前的证据表明，下极结石的治疗存在不确定性，每种治疗方法都有优点和缺点。该试验的目的是确定 FURS 与 ESWL 或 PCNL 相比在治疗下极肾结石方面的临床和成本效益。方法 PUrE（PCNL、FURS 和 ESWL 治疗下极肾结石）试验是一项多中心、随机对照试验 (RCT)，评估 FURS 与 ESWL 或 PCNL 治疗下极肾结石的效果。年龄 >= 16 岁、经肾脏、输尿管和膀胱非增强计算机断层扫描 (CTKUB) 证实任一肾下极有结石且需要治疗 10 毫米至
Introduction Renal stones are common, with a lifetime prevalence of 10% in adults. Global incidence is increasing due to increases in obesity and diabetes, with these patient populations being more likely to suffer renal stone disease. Flank pain from stones (renal colic) is the most common cause of emergency admission to UK urology departments. Stones most commonly develop in the lower pole of the kidney (in similar to 35% of cases) and here are least likely to pass without intervention. Currently there are three technologies available within the UK National Health Service to remove lower pole kidney stones: extracorporeal shockwave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and flexible ureterorenoscopy (FURS) with laser lithotripsy. Current evidence indicates there is uncertainty regarding the management of lower pole stones, and each treatment has advantages and disadvantages. The aim of this trial is to determine the clinical and cost effectiveness of FURS compared with ESWL or PCNL in the treatment of lower pole kidney stones. Methods The PUrE (PCNL, FURS and ESWL for lower pole kidney stones) trial is a multi-centre, randomised controlled trial (RCT) evaluating FURS versus ESWL or PCNL for lower pole kidney stones. Patients aged >= 16 years with a stone(s) in the lower pole of either kidney confirmed by non-contrast computed tomography of the kidney, ureter and bladder (CTKUB) and requiring treatment for a stone 10 mm to