Clinical Efficacy Comparison Of Minimally Invasive Percutaneous Nephrolithotomy And Retrograde Intrarenal Surgery In The Treatment Of Solitary Kidney Stones

Objective: To compare the clinical efficacy of mPCNL and RIRS in the treatment of solitary kidney stonesMethods: we retrospectively analyzed 41 cases of kidney stones in solitary kidney from January 2018 to February 2021 in Yuebei People’s Hospita,of which 26 patients underwent mPCNL and another 15 patients underwent RIRS.All operations were successful.The general conditions(age,sex,diameter of stone,location of stone,type of solitary kidney),operation time,preoperative and postoperative creatinine change value,Intraoperative bleeding volume,hemoglobin reduction value,postoperative hospitalization time,one-session stone-free rate and postoperative complications(fever,bleeding,acute renal failure,stony street,septic shock)were analyzed by statistical method.Results: Two groups successfully completed the operation.There was no significant difference in general conditions(age,sex,diameter of stone,location of stone,type of solitary kidney)between the two group(P >0.05).The results of the two groups were as follows: mPCNL group had higher one-session stone-free rate than the RIRS group(80.8%vs46.7%,P=0.024),the difference was statistically significant(P <0.05);mPCNL group had higher intraoperative bleeding volume than RIRS group(38.27±116.20 ml vs2.67±2.38 ml,P <0.001),the difference was statistically significant(P<0.05);mPCNL group had higher hemoglobin reduction value than RIRS group(13.85±6.82g/L VS7.53±7.93g/L,P =0.011),the difference was statistically significant(P <0.05);mPCNL group had longer postoperative hospitalization time than RIRS group(5.31±1.83 days vs 2.00±1.00 days,P <0.001),the difference was statistically significant(P <0.05).The average operating time in mPCNL group was 75.50±24.04 minutes,The average operating time in RIRS group was 66.00±21.73 minutes,the difference was not statistically significant between the two groups(P >0.05);The average change value of serum creatinine in mPCNL group was 14.81±52.57 umol/L,the average change of serum creatinine in RIRS group was 4.19±18.63umol/L,the difference was not statistically significant between the two groups(P >0.05).mPCNL group had a postoperative complication rate of 9/26(34.6%),six cases of postoperative low fever,one case of postoperative high fever,one case of pleural effusion,one case of postoperative hemorrhage;RIRS group had a postoperative complication rate of 3/15(20%),all 3 cases were postoperative low fever,the difference was not statistically significant between the two groups(P >0.05).Conclusion:Both single‐tract mPCNL and RIRS are effective methods for the treatment in solitary kidney stones,mPCNL have advantage in one-session stone-free rate,RIRS have advantages in intraoperative bleeding volume,hemoglobin reduction value and postoperative hospitalization time.There is no significant difference between the two groups in renal function changes,operation time and postoperative complications.Surgeons should choose surgical approach according to patient status and patient’s wishes.