Abstract:Objective: To compare the efficacy and safety of flexible ureteroscopy vs. percutaneous nephrolithotomy for renal calculi. Methods: From March 2012 to March 2014, 89 patients with renal calcul underwent operation, among them 37 patients were given modular flexible ureteroscopy combined with holmiun laser lithotripsy (URL group), and 52 patients were given percutaneous nephrolithotripsy ultrasound combined with pneumatic lithotripsy (PCNL group). Calculi-free rate and postoperative complication incidence between two groups were compared. Results: In the URL group, hemoglobin was decreased by 0-6 g/L [mean (2.0±2.0) g/L]. The calculi-free rate was 81.1% (30/37). Four patients suffered from mild anemia after the operation, and 3 patients suffered from fever. The complication rate was 18.9% (7/37). In the PCNL group, hemoglobin was decreased 4-36 g/L [mean (13.6±7.4) g/L]. The calculi-free rate was 86.5% (45/52). Twenty-one patients suffered from mild anemia after the operation, 3 patients suffered from moderate anemia, and 4 patients suffered from fever. The complication rate was 53.8% (28/52). Conclusions: PCNL and URL are both minimally invasive surgical procedures for renal calculi, and their efficacy is similar. But as compared with PCNL, URL has the advantages of smaller damage, less bleeding, lower complication rate, and has unique advantages for complex renal calculi such as renal calculi complicated with scoliosis.
[1]Miller NL, Lingeman JE. Management of kidney stones. Br Med J, 2007, 334(7591):468-472. [2]刘星明,任胜强,徐立奇,等.经皮肾镜取石术后大出血的治疗.中国内镜杂志, 2010, 16(9):983-985. [3]刘齐贵,张文滔,段娟,等.输尿管软镜结合钬激光治疗肾结石的疗效观察.中国微创外科杂志, 2012, 12(3):239-241. [4]Nijbore JM, Van Der Horst I, Hendricks HG, et al. Myth or reality: hematocrit and hemoglobin differ in trauma. J Trauma, 2007, 62(5):1310-1312. [5]宋永琳,李炯明,刘建和,等.经皮肾镜钬激光联合超声碎石治疗鹿角形肾结石:附36例报告.中华腔镜泌尿外科杂志:电子版, 2012, 6(3):195-198. [6]Perlmutter AE, Talug C, Tarry WF, et al. Impact of stone location on success rates of endoscopic lithotripsy for nephrolithiasis. Urology, 2008, 71(2):214-217. [7]De La Rosette J, Assimos D, Desai M, et al. The clinical research office of the endourological society percutaneous nephrolithotomy global study: indications, complications, and outcomes in 5803 patients. J Endourol, 2011, 25(1):11-17. [8]Taie K, Jasemi M, Khazaeli D, et al. Prevalence and management of complications of ureteroscopy: a seven-year experience with introduction of a new maneuver to prevent ureteral avulsion. Urol J, 2012, 9(1):356-360. [9]张慕淳,孔祥波,张刚,等.输尿管软镜下钬激光碎石术治疗复杂上尿路结石.中国内镜杂志, 2008, 14(8):810-811, 814. [10]何群,张晓春,那彦群.284例泌尿系结石成分分析与代谢评价.中华泌尿外科杂志, 2005, 26(11):761-764. [11]Weizer AZ, Springhart WP, Ekeruo WO, et al. Ureteroscopic management of renal calculi in anomalous kidneys. Urology, 2005, 65(2):265-269.