Effect of flexible ureteroscopic lithotripsy and microchannel percutaneous nephrolithotripsy on therapeutic effect and complications in patients with 2-3 cm renal calculi
GUO Jun1, LI Zhichun1, REN Zejie1, CHENG Yangsheng1, LI Bo1, SONG Zhongwei1
1 Department of Urology, Wenjiang District People's Hospital, Chengdu 611130, China
Abstract：Objective： To investigate the effect of flexible ureteroscopic lithotripsy (FURL) and micro-channel percutaneous nephrolithotripsy (mPCNL) on the curative effects and complications of 2-3 cm renal calculi. Methods： From January 2017 to December 2018, 120 patients with kidney stones were divided into FURL group and mPCNL group, 60 cases in each group. FURL group was given FURL, and mPCNL group was given mPCNL. The operation time, the time of getting out of bed after operation, the amount of bleeding during operation, the average length of hospital stay, the level of hemoglobin reduction, the occurrence of complications and the rate of stone removal were recorded. VAS score and GCQ score were used to evaluate patients' pain and comfort. Results： The postoperative hospital stay, operation time, time of getting out of bed and time of hemoglobin reduction were significantly shorter, and intraoperative blood loss was significantly in FURL group than those in mPCNL group (all P < 0.05). There was no significant difference in the stone removal rate between the two groups (P > 0.05). The VAS score was significantly lower, and the GCQ score was significantly higher in the FURL group than those in the mPCNL group (both P < 0.05). According to the caiven Dindo criteria, the incidence of complications was 3.33% in FURL group, significantly lower than 13.33% in mPCNL group (P < 0.05). Conclusion： For patients with 2-3 cm renal calculi, the stone removal rate of mPCNL and FURL is similar. FURL has obvious advantages in hospital stay, out of bed activity time, operation time, quality of life after operation and reducing the incidence of complications. With the improvement of equipment and materials, FURL will have greater application prospects, but it should also be reasonably selected according to the specific situations of patients.
郭军, 李知春, 任泽杰, 程洋生, 李波, 宋忠伟. 输尿管软镜碎石术和微通道经皮肾镜碎石术对2~3 cm肾结石患者治疗效果及并发症的影响[J]. 微创泌尿外科杂志, 2020, 9(2): 92-95.
GUO Jun, LI Zhichun, REN Zejie, CHENG Yangsheng, LI Bo, SONG Zhongwei. Effect of flexible ureteroscopic lithotripsy and microchannel percutaneous nephrolithotripsy on therapeutic effect and complications in patients with 2-3 cm renal calculi. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(2): 92-95.
[1] 李建兴,肖博.儿童肾结石的腔内微创治疗策略(附光盘).现代泌尿外科杂志,2015,20(12):841-843. [2] 韩利忠,李明明,卢冠军,等.经皮肾镜联合腔内切开手术治疗肾结石合并肾盂输尿管连接部梗阻.中国微创外科杂志,2018,18(5):409-411. [3] 胡嘏,杨俊,夏丁,等.经皮输尿管镜激光肾囊肿去顶术治疗肾囊肿的安全性和有效性.中华泌尿外科杂志,2017,38(1):1-4. [4] 陈南辉,陈智林,黄志成,等.输尿管软镜下钬激光碎石治疗经皮肾镜取石术后残留结石.中华腔镜泌尿外科杂志(电子版),2013,7(6):32-34. [5] 徐城,杨晓秋,刘丹彦.常用的疼痛评估方法在临床疼痛评估中的作用.中国疼痛医学杂志,2015,21(3):210-212. [6] 朱婷,刘红霞,胡文君,等.改良舒适度量表在加速康复外科护理中的应用.护士进修杂志,2018,33(12):1138-1140. [7] FESOY O, TEK M, BOZLU M, et al.Comparison of single-session aspiration and ethanol sclerotherapy with laparoseopic de-roofing in the management of symptomatic simple renal cysts. Turk J Urol, 2015,41(2):14-19. [8] 平秦榕,李健,张宏景,等.输尿管软镜治疗中上盏肾结石术后无管化的临床研究.中华泌尿外科杂志,2019,40(2):100-104. [9] 王飞,张宇,陈乐仲,等.微通道经皮肾镜与逆行输尿管软镜碎石治疗对2-4cm肾结石患者血清炎性因子的影响.实用医学杂志,2018,34(16):2716-2721. [10] WESTWOOD M, RAMAEKERS B, WHITING P, et al. Procalcitonin testing to guide antibiotic therapy for the treatment of sepsis in intensive care settings and for suspected bacterial infection in emergency department settings: a systematic review and cost-effectiveness analysis. Health Technol Assess, 2015,19(96):v-xxv,1-236. [11] 孙翔,习海波.经皮肾镜取石术治疗老年肾结石患者出血的危险因素.中国老年学杂志,2016,36(11):2708-2709. [12] 谢国海,严泽军,蒋军辉,等.可视穿刺针肾镜系统经超微通道(F12)治疗<2 cm肾结石的初步经验.中华泌尿外科杂志,2018,39(3):214-217. [13] SSIMOS D, KRAMBECK A, MILLER NL, et al.Surgical management of stones:American urological association/endourological society guideline, part 11. J Urol, 2016,196(3):1161-1169. [14] 梁福律,涂建平,林剑峰,等.超微经皮肾镜取石术治疗2-2.5cm肾结石.中国微创外科杂志,2018,18(12):1137-1138,1142. [15] HOT S, EGIN S, Cokcek B, et al.Solitary caecum diverticulitis mimiching acute appendicitis. Ulus Travma Acil Cerrahi Derg, 2015,21(6):520-523.
