Comparison Of Flexible Ureteroscopy And Percutaneous Nephrolithotomy For Staghorn Calculi:a Single Center Randomized Controlled Study

Objective:To evaluate the efficacy and safety of flexible ureteroscopy VS percutaneous nephrolithotomy in the treatment of staghorn calculi.MethodsFrom september2011to march2014,60patients with renal staghorn caculi treated in SIR RUN RUN SHAW hospital were selected. They were randomized in flexible ureteroscopy group(n=30) and percutaneous nephroluthoto group(n=30). Compare the operative time, amount of bleeding during operation, preoperative and postoperative hemoglobin concentrations and CRP, hospitalization time after operation, total cost, stone-free rate and preoperative complications between the two groups.ResultsThe two groups had no significant difference in Age, Sex, Hydronephrosis, S.T.O.N.E. Nephrolithometry scores(P>0.05).The operative time of FURS group and PCNL group were respectively (102.9±40.2)min and (136.9±46.6)min; Amount of bleeding during operation were (20.5±20.0)ml and (102.4±240.8)ml; hospitalization time after operation were (2.6±1.2)d和(5.3±1.8)d; Total cost were (24.5±6.8) thousand yuan and (28.6±5.4) thousand yuan; After operate, hemoglobin concentrations declined (0.89±0.69)g/L and(1.48±0.98)g/L; they all had a significant difference(P>0.05).The CRP rise(2.59±1.16)mg/L in FURS group and (5.55±6.81)mg/L in PCNL group, they had no significant difference(P<0.05). Blood transfusion percentage of in the two groups were0%and3.33%. Incidence of complications (Clavein degree Ⅱ) were6.67%(2/30)and10%(3/30). In FURS group,1patient had infection and fever,1had retroperitoneal inflammation. In PCNL group,1patient had perirenal hematoma,1patient had pleural effusion and fever,1patient need transfusion of blood after surgery. The stone-free rate were86.7%(26/30) and90%(27/30), they had no significant difference(P<0.05). But in the FURS group,8patient underwent ESWL, and in the PCNL group, only1patient receive ESWL after sugery.ConclusionBoth Flexible ureteroscopy and percutaneous nephrolithotomy are feasible, safe and minimally invasive way to treat renal staghorn calculi. But FURS has an advantage in operative time, amount of bleeding during operation, hospitalization time after operation and total cost.