Comparison of clinical efficacy between flexible ureteroscopic lithotripsy and percutaneous nephrolithotomy lithotomy in the treatment of upper ureteral calculi
Zhao Yawei1, Zong Shi1, Hou Yi1, Tan Jiufeng1, Kong Xiangbo1, Wang Zhixin1
1Department of Urology, China-Japan Union Hospital, Jilin Uniersity, Changchun 130000, China
Abstract：Objective: To compare the clinical efficacy of flexible ureteroscopic lithotripsy vs. percutaneous nephrolithotomy lithotomy in the treatment of upper ureteral calculi. Methods: Between June 2013 and June 2015, a total of 151 patients with upper ureteral calculi (long diameter >2 cm) were treated in China-Japan Union Hospital of Jilin University. Among them, there were 63 cases previously treated with extracorporeal lithotripsy, 45 cases of severe renal pelvis, 48 cases previously with ureteral hard mirror surgery, 17 cases of ureteral calculi, and 23 cases of upper ureteral calculi. Sixty-two patients were given flexible ureteroscopy as experimental group, and 89 patients underwent percutaneous nephrolithotomy as control group. The operation time, surgical complications, stone-free rate, postoperative hospital stay in two groups were statistically analyzed. Results: In experimental group and control group, age was (47.9±9.1) and (49.6±11.9) years (P=0.605), the ration of male/female was 33/29 and 40/49, stone diameter was (29.2±5.6) and (30.4±6.6) mm (P>0.05), operation time was (77.1±10.1) and (42.4±6.2) min (P<0.001), total complication rate was 12.90% and 26.97% (P=0.167), stone-free rate after a single procedure (residual ≤3 mm)was 83.9% and 87.6% (P>0.05), and postoperative hospital stay was (2.7±0.7) and (5.1±0.7) days (P<0.001) respectively. Conclusions: Both flexible ureteroscopic lithotripsy and percutaneous nephrolithotomy lithotomy are effective and safe surgical procedures for patients with upper ureteral calculi. Percutaneous nephroscope shortens the operation time. But with the development of new technology, flexible ureteroscopy has been applied widely. It has advantages such as minimal invasion and shorter hospitalization time, etc. The surgeons need to balance various factors such as the pathological and physiological conditions of patients, equipment conditions, and choose the most appropriate treatment.
赵亚伟,宗实,侯毅,谭九峰,孔祥波,王志新. 软性输尿管镜和经皮肾镜治疗输尿管上段结石的对比分析[J]. 微创泌尿外科杂志, 2015, 4(6): 344-347.
Zhao Yawei , Zong Shi , Hou Yi , Tan Jiufeng , Kong Xiangbo , Wang Zhixin. Comparison of clinical efficacy between flexible ureteroscopic lithotripsy and percutaneous nephrolithotomy lithotomy in the treatment of upper ureteral calculi. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2015, 4(6): 344-347.
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