Comparison of short-term and long-term effects of flexible ureteroscopy lithotripsic and tubeless minimally invasive percutaneous nephrolithotomy in the treatment of ≤2.0 cm kidney stone
WANG Tao1, WANG Hongmao1, LI Xilin1, HE Hua1, WANG Lihui2
1 Department of Urology, Jianghan Oilfield General Hospital, Qianjiang 433100, China; 2 Department of Surgery,Three Gorges Hospital of Chongqing University
Abstract：Objective： To compare the efficacy of flexible ureteroscopy lithotripsic (FURL) and tubeless minimally invasive percutaneous nephrolithotomy (TMPCNL) for ≤ 2.0 cm kidney stone. Methods： The clinical data of 82 patients with kidney stone in our hospital from June 2017 to June 2019 were retrospectively analyzed, and the patients were divided into FURL group (n=40) and TMPCNL (n=40) according to the voluntary selection of surgical methods. The operation time, postoperative hemoglobin decrease, postoperative leukocyte elevation and hospitalization time were observed in the two groups. The stone clearance rate, postoperative complications and persistent high incidence were statistically analyzed in the two groups 2 days and 1 month after operation. The content of kidney injury molecule-1 (KIM-1) in urine and cystine C in serum (CysC) were measured in the two groups before operation, 1 day after operation and 5 days after operation. The scores of pain visual analogue scale (VAS) and Wisconsin Quality of Life Questionnaire (WISQOL) were recorded at the time of admission and 2 weeks after discharge. Results： There was no significant difference in leukocyte elevation between the two groups after operation (P > 0.05). The operation time in the FURL group was significantly longer than that in the TMPCNL group (P < 0.05). The postoperative hemoglobin decrease and hospitalization time in the FURL group were significantly reduced as compared with those in the TMPCNL group (P < 0.05). The stone clearance rate in FURL group 2 days after operation was significantly lower than that in TMPCNL group (P < 0.05), but there was no significant difference in stone clearance rate between the two groups 1 month after operation (P > 0.05). The incidence of postoperative complications and persistent high fever rate in the FURL group were significantly lower than those in the TMPCNL group (P < 0.05). There was no significant difference in the content of KIM-1 and CysC between the two groups before and 5 days after operation (P > 0.05). The content of KIM-1 in the FURL group 1 day after operation was significantly lower than that in the TMPCNL group (P < 0.05), and the content of CysC in the FURL group 1 day after operation was significantly higher than that in the TMPCNL group (P < 0.05). The VAS score after operation in the FURL group was significantly lower than that in the TMPCNL group (P <0 .05), and the WISQOL score after operation in the FURL group was significantly higher than that in the TMPCNL group (P < 0.05). Conclusions： The two surgical methods were effective in the treatment of kidney stones of ≤ 2.0 cm, of which the FURL had such characteristics as long operation time, short hospital stay and small injury to renal tubules and glomeruli after operation, moreover, the postoperative complications, pain and the quality of life were better than the TMPCNL. The long-term stone clearance rate of the two methods was the same, but the short-term stone clearance rate of FURL was not as good as that of TMPCNL.
王涛, 王宏茂, 李夕林, 何华, 王丽晖. 输尿管软镜碎石与无管化微创经皮肾镜取石对≤2.0 cm肾结石近远期疗效对比[J]. 微创泌尿外科杂志, 2020, 9(2): 86-91.
WANG Tao, WANG Hongmao, LI Xilin, HE Hua, WANG Lihui. Comparison of short-term and long-term effects of flexible ureteroscopy lithotripsic and tubeless minimally invasive percutaneous nephrolithotomy in the treatment of ≤2.0 cm kidney stone. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(2): 86-91.
