Efficacy and safety of ureteroscopic lithotripsy combined with minimally invasive percutaneous nephrolithotomy for the treatment of incarcerated ureteral calculi
ZHANG Muchun1, GU Anna2, ZHAO Zhiyi3
1 Department of Urology, the First Hospital of Jilin University, Changchun 130021, China; 2 Department of Urology, China-Japan Union Hospital of Jilin University; 3 Department of Respiratory, China-Japan Union Hospital of Jilin University
Abstract：Objective： To evaluate the efficacy and safety of ureteroscopic lithotripsy combined with minimally invasive percutaneous nephrolithotomy for the treatment of incarcerated ureteral calculi. Methods： Sixty-four patients with incarcerated ureteral calculi admitted to our hospital from January 2017 to May 2018 were enrolled. The patients were divided into observation group and control group using the random number grouping method with 32 cases in each group. Patients in the control group underwent minimally invasive percutaneous nephrolithotomy, and those in the observation group were treated with minimally invasive percutaneous nephrolithotomy and ureteroscopy. The operation time, postoperative hospital stay, stone clearance rate, renal function indexes [including serum creatinine (SCr) and blood urea nitrogen (BUN)], serum C-reactive protein (CRP) levels before and after treatment, postoperative pain degree and complication rate were compared between the two groups. Results： The operation time in the observation group was significantly longer than that in the control group (P<0.05). The postoperative hospital stay was significantly shorter in the observation group than in the control group (P<0.05). There was no significant difference in the first-stage stone clearance rate and the second-stage stone removal rate between the two groups (P>0.05). Before treatment, there was no significant difference in BUN and SCr between the two groups (P>0.05). After treatment, the serum CRP levels in the two groups were increased significantly (P<0.05), and the serum CRP levels in the observation group were lower than those in the control group (P<0.05). The incidence of grade Ⅱ and Ⅲ pain in the observation group was 15.62%, which was lower than that in the control group (46.87%) (P<0.05). The complication rate in the observation group was 6.25% and 9.38% in the control group with the difference being not statistically significant (P>0.05). Conclusion： Ureteroscopy with minimally invasive percutaneous nephrolithotomy for the treatment of incarcerated ureteral calculi is equivalent to minimally invasive percutaneous nephrolithotomy in combination with minimally invasive percutaneous nephrolithotomy. And the inflammatory response is mild and worthy of clinical promotion.
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