Efficacy of transurethral ureteroscopic lithotripsy versus retroperitoneal laparoscopic ureterolithotomy in the treatment of upper ureteral calculi / 中国基层医药

ABSTRACT

Objective:To explore the effects of retroperitoneal laparoscopic ureterolithotomy (RLU) and urethral ureteroscopic lithotripsy (URL) on renal function, oxidative stress, and immunoglobulin levels in patients with upper ureteral calculi.Methods:The clinical data of 78 patients with upper ureteral calculi, who received treatment in Yiwu Central Hospital from June 2017 to April 2020, were collected for this study. The patients were divided into URL group ( n = 38, URL treatment) and RLU group ( n = 40, RLU treatment) according to different surgical methods. Renal function (creatinine, urea nitrogen, neutrophil gelatinase-associated lipocalin), oxidative stress (superoxide dismutase, malondialdehyde), immunoglobulin (Ig) (IgA, IgM, IgG), and complications were compared between the two groups. Results:At 1 day after surgery, creatinine, urea nitrogen, neutrophil gelatinase-associated lipocalin in the RLU group were (79.59 ± 6.02) μmol/L,(6.93±1.17) mmol/L,(4.78±0.61) μg/L, respectively, which were significantly lower than those in the URL group [(86.98 ± 8.27) μmol/L, (7.62 ± 1.24) mmol/L, (6.03 ± 0.79) μg/L, t = 4.53, 2.53, 7.85, P < 0.001, P = 0.014, P < 0.001). At 1 day after surgery, IgA, IgM, and IgG in the RLU group were (1.94 ± 0.25) g/L, (1.55 ± 0.24) g/L, (6.59 ± 1.25) g/L, respectively, which were significantly lower than those in the URL group [(2.38 ± 0.23) g/L, (1.82 ± 0.27) g/L, (7.89 ± 1.36) g/L, t = 8.08, 4.67, 4.40, P < 0.001, 0.001, 0.001]. At 1 day after surgery, malondialdehyde level was significantly lower in the RLU group than in the URL group [(7.49 ± 1.26) mmol/L vs. (8.93 ± 1.38) mmol/L, t = 4.817, P < 0.001]. At 1 day after surgery, superoxide dismutase level was significantly higher in the RLU group than in the URL group [(72.18 ± 7.55) mg/L vs. (63.49 ± 6.69) mg/L, t = 5.37, P < 0.001). There was no significant difference in the incidence of postoperative complications [15.79% (6/38) vs. 7.50% (3/40), χ2 = 1.31, P = 0.252]. Conclusion:RLU for the treatment of upper ureteral calculi has fewer effects on renal function, oxidative stress, and immunoglobulin level in patients with upper ureteral calculi compared with URL and does not increase the incidence of complications.