Effectiveness and safety of combined lithotripsy and percutaneous nephrolithotomy in the treatment of upper ureteral calculi with ipsilateral renal calculi
SHEN Xuecheng1, SUN Jing2, XIONG Zhaohui1, ZHAO Benlong1, WEI Yangyang1, SHEN Junchao1, PAN Jinsheng1
1 Kidney Disease Center, Chinese People's Armed Police Force, Hefei 230041, China; 2 Hospital Office,Anhui Provincial Corps Hospital, Chinese People's Armed Police Force, Hefei 230041, China
Abstract：Objective: To compare the effectiveness and safety of retroperitoneal laparoscopic ureterectomy （RLUL） combined with choledochoscopy （COC） and percutaneous nephrolithotomy in the treatment of upper ureteral calculi combined with ipsilateral renal calculi, in order to more rationally treat upper ureteral calculi combined with ipsilateral kidney stones. Methods： A retrospective analysis was done on the clinical data of patients with upper ureteral calculi and ipsilateral renal calculi who underwent RLUL+COC （n = 48） and PCNL （n = 46） treatments in our hospital from February 2018 to April 2020. The general data, perioperative indicators, stone removal rate and complications were compared between the two groups. Results： The operation time, intraoperative blood loss, and length of hospital stay in the RLUL+COC group were significantly reduced as compared with those in the PCNL group （P < 0.05）. The stone clearance rate （95.83%） in the RLUL+COC group was significantly higher than in the PCNL group （82.61%） （P < 0.05）. The incidence of complications in the RLUL+COC group （8.33%） was significantly lower than that in the PCNL group （17.39%） （P < 0.05）. Conclusion： RLUL+COC is safe and effective for treating upper ureteral calculi with ipsilateral renal calculi, with less trauma, higher stone removal rate, fewer complications, and quicker postoperative recovery than PCNL.
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