Comparison of the effects of three minimally invasive treatment methods for complicated upper ureteral calculi / 中国基层医药

ABSTRACT

Objective:To compare the efficacy and safety of three minimally invasive methods, transurethral rigid ureteroscopic holmium laser lithotripsy (URL), transurethral flexible ureteroscopic holmium laser lithotripsy (FURS), and percutaneous nephroscopic holmium laser lithotripsy (PCNL), in the treatment of complicated upper ureteral calculi.Methods:The clinical data of 60 patients with complex upper ureteral calculi admitted to the urology department of the Second People's Hospital of Wuhu from January 2016 to December 2018 were retrospectively analyzed.All patients were divided into three groups according to treatment methods: URL group (20 cases), FURS group (20 cases) and PCNL group (20 cases). The efficacy of the three methods was compared in terms of stone removal rate, operation time, intraoperative and postoperative bleeding, length of hospital stay and other indicators.Results:The success rate of one-time lithotripsy in the URL group was significantly lower than that in the FURS group and the PCNL group(FURS vs.URL, χ 2=5.83, P<0.05, URL vs.PCNL, χ 2=8.03, P<0.05). The operative time(FURS vs.PCNL, t=2.436, P<0.05, URL vs.PCNL, t=2.634, P<0.05), hospital stay, intraoperative and postoperative bleeding in the URL group and FURS group were significantly less than those in the PCNL group(FURS vs.PCNL, t=2.243, P<0.05, URL vs.PCNL, t=2.320, P<0.05). There were no statistically significant differences among intraoperative, postoperative infection, fever, renal colic and other complications (all P>0.05). Conclusion:FURS in the treatment of complicated upper ureteral calculi, the one-time stone removal rate is better than URL operation, compared with PCNL, the intraoperative and postoperative bleeding is significantly less than the latter, and the operative time and hospital stay are shorter than PCNL.It is suggested that FURS operation should be given priority in the treatment of complicated upper ureteral calculi.