Preliminary application of laparoscopic technique in treatment of upper urinary calculi / 中国内镜杂志

ABSTRACT

Objective To evaluate the reasonable individual program for upper urinary tract calculi in minimally invasive treatment. Methods From January 2013 to June 2016, 147 patients (sides) with upper urinary calculi who had some characteristics received laparoscopic nehprectomy or corresponding surgical treatment. The number of cases of postoperative stagnation, the average hospitalization time and the average cost of treatment were compared with those of 147 patients (lateral) who underwent PCNL and URSL with the similarity, shape and load of stones before June 2016, respectively. Results The removal rate of stage I was 100.00％ (147/147) in laparoscopic group, which was significantly higher than that in PCNL and URSL group (91.84％, 135/147), the difference was statistically significant (P = 0.001); Laparoscopic group postoperative blood transfusion (0/147) and interventional hemostasis (0/147) were significantly lower in 6 cases (6/147) and 4 cases (4/147) in PCNL and URSL groups,the differences were statistically significant (P = 0.013, P = 0.044). There was no postoperative severe infection in laparoscopic group (0/147), which has no significant difference (P = 0.156) in postoperative severe infection between PCNL and URSL group (2/147). There were 9 cases of 134 cases of postoperative (9/134) fever at ≥ 38℃ in laparoscopic group, which was significantly lower than that in PCNL and URSL group (28/147), the difference was statistically significant (P = 0.002); Laparoscopic group of postoperative urinary tract stenosis in 3 cases (3/114), which was significantly lower than that of PCNL and URSL group (9/101), the difference was statistically significant (P = 0.045). The average length of stay in laparoscopic group was (10.12 ± 0.29) d, which was significantly lower (P = 0.011) than that in PCNL and URSL group (13.97 ± 0.38) days. The average cost of treatment in laparoscopic group (12541.84 ± 181.54) yuan was significantly lower than that in PCNL and URSL group (18124.65 ± 302.32) yuan, the difference was statistically significant (P = 0.018). Conclusion In some cases, when the upper urinary tract calcuci are suitable for 'cut out', the use of laparoscopic treatment is more secure; when there is a need for surgical treatment of complications, can be treated simultaneously. Laparoscopic technique is one of the important methods of minimally invasive treatment for upper urinary calculi.