Comparison Of The Efficacy Of Laparoscopic Ureterolithotomy And Percutaneous Nephrolithotomy For Upper Ureteral Stones

OBJECTIVE:To compare the efficacy and safety of laparoscopic ureterolithotomy and percutaneous nephrolithotomy for upper ureteral stones.Methods:A retrospective analysis of 72 patients with upper ureteral calculi in the Second Department of Urology of the First Clinical College of Jilin University from 2018 to 2019.According to the surgical method,they were divided into laparoscopy group(observation group A)and percutaneous nephroscope group(observation group B).There were 41 cases in observation group A: 23 males and 18 females;aged 20 to 69 years,with an average age of 54.21 ± 11.85 years;stones were distributed in 19 cases on the left and 22 cases on the right.There were 31 cases in observation group B: 17 males and 14 females;aged 22 to 67 years,with an average age of 52.88 ± 14.65 years;stones were distributed in 16 cases on the left and 15 cases on the right.By comparing the operation time,postoperative hemogram,hemoglobin and renal function changes,the length of hospital stay and cost,the rate of stone removal,and the incidence of postoperative complications,the clinical effects and safety of the two groups were compared.Data analysis was performed using SSPS26.0 statistical software.The mean and standard deviation of the data are expressed as(x ± s).The comparison of relevant indicators before and after surgery in the two groups was performed by t test,Z test,and chi-square test.When P <0.05,the two groups were described.Patient data were statistically significant.Results:The age,gender,stone diameter,and stone distribution of the two groups of patients were not statistically significant,and were comparable.The changes in hemoglobin before and after surgery in the two groups were 5.54 ± 10.31VS14.53 ± 23.32(g / L),P was 0.01,which was statistically significant;the hospital stay in the two groups was 8.09 ± 1.94VS11.92 ± 2.38 days,The P value was divided into 0.000,and the hospitalization cost was 25713.68 ± 4437.46VS28452.69 ± 5006.12 yuan,and the P value was 0.001,which was statistically significant.The operation time of the 2 patients was slightly longer in the LU group than in the PCNL group.Learn the difference.The values of WBC change,creatinine change,and calculus rate P were all greater than 0.05,which were not statistically significant.the postoperative complications of the two groups of patients have similar incidence of postoperative fever,blood transfusion rate and postoperative analgesic use rate The PCNL group was higher than the LU group,but the incidence of postoperative urinary leakage / ureteral stenosis was lower than the LU group.in conclusion:1.For upper ureteral stones,laparoscopic ureterotomy(LU)and percutaneous nephrolithotomy(PCNL)have good therapeutic effects.2.The risk of postoperative bleeding in the LU group is lower than that of PCNL,and it has an advantage in hospitalization time and cost,but PCNL has an advantage in the risk of postoperative urine leakage or ureteral stenosis and the duration of surgery.Pros and cons,clinically should be flexibly selected according to the patient’s condition and the proficiency of the surgeon.