Therapeutic effect of flexible ureteroscopic lithotripsy and NTrap ureteroscopic lithotripsy in the treatment of upper ureteral calculi / 国际外科学杂志

ABSTRACT

Objective:To compare the efficacy of flexible ureteroscopic lithotripsy (FURL) and NTrap ureteroscopic lithotripsy (NTrapURL) in the treatment of upper ureteral calculi.Methods:A retrospective analysis of the case data of 243 patients undergoing unilateral upper ureteral calculi lithotripsy admitted to the First Hospital of China Medical University from January 2012 to March 2018 were divided into two groups according to different treatment methods: FURL group ( n=74) and NTrapURL group ( n=169). Patients in the FURL group were treated with FURL, and patients in the NTrapURL group were treated with NTrapURL. Operation time, intraoperative stone moving up, postoperative meaningless residual stone, postoperative hospitalstay, stone-free rate, short-term complications (including pain, hematuria, fever) and long-term complications (including ureteral stenosis) were recorded, two surgical methods were analyzed. The measurement data conforming to the normal distribution were expressed as mean±standard deviation ( Mean± SD), and the independent sample t-test was used for comparison between groups; the measurement data of non-normal distribution were expressed as the median (interquartile range) [ M( P25, P75)] means that the non-parametric rank sum test of independent samples was used for comparison between groups; the Chi-square test or Fisher exact probability method was used for the comparison of count data between groups, and the nonparametric rank sum test of ordinal variables was used for grade data. Results:There was not statistically significant difference between the operation time of patients in the FURL group and the NTrapURL group [(31.08±13.29) min vs (33.49±12.10) min]( P=0.582). There was no difference in short-term complications (pain 43.24% vs 50.30%, fever 1.35% vs 3.55%, hematuria 31.08% vs 23.67%) and long-term complications (0 vs 3.55%) in the FURL group and NTrapURL group, there was not statistically significant difference ( P>0.05); the postoperative hospital stay of patients in the FURL group and NTrapURL group [(2.34±0.96) d vs (2.21±0.88) d], the difference was not statistically significant ( P>0.05); The intraoperative stone movement rate of FURL group was significantly higher than that of the NTrapURL group (87.84% vs 18.93%), and the difference was statistically significant ( P<0.001); the first stone clearance rate of the FURL group was higher than that of the NTrapURL group (94.59% vs 81.07%), the difference was statistically significant ( P=0.006); the postoperative insignificant residual stone rate in the FURL group was significantly higher than that in the NTrapURL group (31.08% vs 18.34%), and the difference was statistically significant ( P=0.043). Conclusion:FURL and NTrapURL are safe and effective in the treatment of upper ureteral calculi, but FURL has a higher stone-free in the treatment of upper ureteral calculi.