A comparative study of rigid combined flexible ureteroscope homium laser lithotripsy with rigid ureteral access sheath and mini-percutaneous nephrolithotomy for pelvic calculi
Abstract：Objective: To compare the clinical efficacy and safety of rigid combined flexible ureteroscope homium laser lithotripsy with rigid ureteral access sheath and mini-percutaneous nephrolithotomy for pelvic calculi. Methods: Between March 2012 and December 2013,of the total 132 cases, seventy-three cases underwent rigid combined flexible ureteroscope homium laser lithotripsy with rigid ureteral access sheath (group A), and 59 cases underwent mini-percutaneous nephrolithotomy (group B). The operating time, hemoglobin decreased value, postoperation hospital stay time, stone residue rate and complication were compared between the two groups. Results: There was no significant difference between the two groups in terms of age, gender, course of disease, position, degree of hydronephrosis and stone size (P＞0.05). 66 cases of the total 73 cases in group A were completed successfully in the first procedure. The mean operating time was (40.3±8.3)min. The decreased mean hemoglobin value was (1.3±5.7)g/L. The mean post-operative hospital stay was (2.2±0.7)days. The stone residue rate was 9.1%. 2 cases had fever after operation. One case was suffered with renal colic. No case was suffered with ureteral transaction, avulsion, the renal pelvis tearing or other serious complications. No case was suffered with ureteral reflux after three months following-up. All of the 59 cases in group B were completed successfully. The mean operating time was (74.6±12.2)min. The decreased mean hemoglobin value was (20.4±10.4)g/L. The mean post-operative hospital stay was (5.1±0.7) days. The stone residue rate was 5.1%. Except 2 cases were suffered with massive hemorrhage,no case was suffered with another serious complications. The operating time, the decreased hemoglobin value and the post-operative hospital stay time had significant difference between the two groups (P＜0.05). The stone residue rate and complication rate were not significantly different between the two groups (P＞0.05). Conclusions: Of the two surgical technique, the rigid combined flexible ureteroscope homium laser lithotripsy with rigid ureteral access sheath has more advantages for the shorter operating time, less trauma, faster recovery,and lower severity of complications for pelvic calculi.
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