Abstract:Objective: To investigate the clinical efficacy and safety of MPCNL and FURS for pyelolithiasis with diameter of 2-3 cm. Methods: The clinical data of 173 cases of pyelolithiasis with diameter of 2-3 cm were retrospectively analyzed in the period from January 2016 to January 2019 in our hospital. The patients were divided into two groups including MPCNL group (n=93 given MPCNL) and FURS group (n=80 given FURS). The lithiasis clearance rate, the levels of surgical related indicators, inflammatory related factors after operation and incidence of postoperative complications were compared between two groups. Results: There was no significant difference in the lithiasis clearance rate between 2 groups (P > 0.05). The operation time and total treatment cost in FURS group were significantly increased as compared with those in MPCNL group (P < 0.05). The Hb decline level and hospitalization time in FURS group were significantly reduced as compared with those in MPCNL group (P < 0.05). There was no significant difference in the inflammatory related factors and the incidence of postoperative complications after operation between 2 groups (all P > 0.05). Conclusion: Compared with MPCNL, FURS in the treatment of pyelolithiasis with diameter of 2-3 cm possesses the same lithiasis clearance effects and safety, and can efficiently alleviate iatrogenic trauma degree and shorten hospitalization time.
吴运海, 郝强, 胡彬, 贾洪涛. 微通道经皮肾镜碎石术和输尿管软镜碎石术治疗直径2~3 cm单发肾盂结石的疗效及安全性研究[J]. 微创泌尿外科杂志, 2020, 9(3): 166-170.
WU Yunhai, HAO Qiang, HU Bin, JIA Hongtao. Clinical efficacy and safety of MPCNL and FURS for pyelolithiasis with diameter of 2-3 cm. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(3): 166-170.
[1] LOFTUS CJ, HINCK B, MAKOVEY I, et al.Mini versus standard percutaneous nephrolithotomy: the impact of sheath size on intrarenal pelvic pressure and infectious complications in a porcine model. J Endourol, 2018,32(4):350-353. [2] GUPTA S, DAS SK, PAL DK.Total tubeless ultra-mini supine percutaneous nephrolithotomy: A feasibility study. Turk J Urol, 2018,44(4):323-328. [3] TÜRK C, PETŘÍK A, SARICA K, et al. EAU guidelines on interventional treatment for urolithiasis. Eur Urol, 2016,69(3):475-482. [4] WANG Q, GUO J, HU H, et al.Rigid ureteroscopic lithotripsy versus percutaneous nephrolithotomy for large proximal ureteral stones: A meta-analysis. PLoS One, 2017,12(2):e0171478. [5] 那彦群,叶章群,孙颖浩,等.中华泌尿外科疾病诊断治疗指南.北京:人民卫生出版社,2014:137. [6] JONES P, ELMUSSAREH M, ABOUMARZOUK OM, et al.Role of minimally invasive (micro and ultra-mini) PCNL for adult urinary stone disease in the modern era: evidence from a systematic review. Curr Urol Rep, 2018,19(4):27-35. [7] WRIGHT A, RUKIN N, SMITH D, et al.'Mini, ultra, micro' - nomenclature and cost of these new minimally invasive percutaneous nephrolithotomy (PCNL) techniques. Ther Adv Urol, 2016,8(2):142-146. [8] TAKAZAWA R, KITAYAMA S, TSUJII T.Appropriate kidney stone size for ureteroscopic lithotripsy: When to Switch to a percutaneous approach. World J Nephrol, 2015,4(1):111-117. [9] DESAI JD.Prospective outcomes of 11-13Ch.ultra-mini percutaneous nephrolithotomy (UMP): A consecutive cohort study. Arch Esp Urol, 2017,70(1):202-210. [10] KARAKAN T, KILINC MF, BAGCIOGLU M, et al.Comparison of ultra-mini percutaneous nephrolithotomy and micro-percutaneous nephrolithotomy in moderate-size renal stones. Arch Esp Urol, 2017,70(5):550-555. [11] HAGHIGHI R, ZERAATI H, GHORBAN MZ.Ultra-mini-percutaneous nephrolithotomy (PCNL) versus standard PCNL: A randomised clinical trial. Arab J Urol, 2017,15(4):294-298. [12] AGRAWAL MS, AGARWAL K, JINDAL T, et al.Ultra-mini-percutaneous nephrolithotomy: A minimally-invasive option for percutaneous stone removal. Indian J Urol, 2016,32(2):132-136. [13] DEMIRBAS A, RESORLU B, SUNAY MM, et al.Which should be preferred for moderate-size kidney stones? Ultramini percutaneous nephrolithotomy or retrograde intrarenal surgery? J Endourol, 2016,30(12):1285-1289. [14] HAN DH, JEON SH.Stone-breaking and retrieval strategy during retrograde intrarenal surgery. Investig Clin Urol, 2016,57(4):229-230. [15] BERARDINELLI F, PROIETTI S, CINDOLO L, et al.A prospective multicenter European study on flexible ureterorenoscopy for the management of renal stone. Int Braz J Urol, 2016,42(3):479-486. [16] KO YH, JI YS, PARK SY, et al.Procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculi. Int Braz J Urol, 2016,42(2):270-276.