A Retrospective Study Of One-time Electronic Flexible Ureteroscopic Lithotomy(FURL) And Mini-PCNL In The Treatment Of Lower Calycal Stones ≤2cm

Objective By analyzing the medical records of patients with lower calycal stones ≤2cm treated by one-time electronic flexible ureteroscopic lithotomy(FURL)and microchannel percutaneous nephrolithotomy(mini-PCNL)in our hospital from January 2018 to November 2021,The safety and effectiveness of mini-PCNL and done-time electronic flexible ureteroscopic lithotomy(FURL)in the treatment of lower calycal stones ≤2cm were compared to explore the ideal surgical method for the treatment of lower calycal stones ≤2cm.Methods Intraoperative,and postoperative clinical data of 66 patients with lower calycal stones ≤ 2cm who underwent one-time electronic flexible ureteroscopic lithotomy and mini-PCNL were retrospectively collected from January 2018 to November 2021 in a hospital.66 patients were divided one-time electronic flexible ureteroscopic lithotomy group(FURL group)and micro-channel percutaneous nephrolithotripsis group(mini-PCNL group)according to surgical methods,including 31 patients in the FURL group and 36 patients in the Mini-PCNL group.Population of two groups of patients with baseline information collection(including gender,age,whether merger whether hypertension medical history,history of diabetes mellitus,etc.)and imaging data(including location,size,number,density,the infundibulopelvic angle,etc.),laboratory test data(including urine dry chemistry and sediment,routine blood,liver and kidney function,blood glucose,stone composition analysis,etc.),information related to the operation data(including surgical method,operation start and end time,intraoperative blood loss,etc.),postoperative related data(including postoperative hospital stay,postoperative stone clearance rate,etc.).Statistical analysis of the above information,the use of SPSS 18.0 software,measurement data using t test,counting data by chi-square test,analysis of the two groups of patients with postoperative 3 day and 30 day stone clearance rate,operation time,intraoperative blood loss,the total length of hospital stay,postoperative hospital stay,postoperative complications and hospitalization expenses of differences and analyzes its reason.Result There There was no significant difference in the demographic baseline data of66 patients between the two groups(P>0.05).The stone size,CT value and postoperative serum average creatinine value of the FURL group were lower than those of the MiniPCNL group,but the differences were not statistically significant(P>0.05).The amount of intraoperative blood loss,total hospital stay and postoperative hospital stay in the FURL group were lower than those in the Mini-PCNL group,and the differences were statistically significant(P< 0.05).The short-term stone clearing rate(SFR)in FURL group was significantly lower than that in m PCNL group(P =0.007),but there was no significant difference in SFR at 30 days between the two groups(P > 0.05).In addition,the operative time of FURL group was lower than that of mini-PCNL group,but there was no significant difference between the two groups(P > 0.05).The total incidence of complications in the FURL group was lower than that in the Mini-PCNL group(9.6%,22.9%,P < 0.05).The treatment cost of FURL group was higher than that of Mini-PCNL group,and the difference was statistically significant.(P < 0.05);The average IPA of FURL group was higher than that of mini-PCNL group,and the difference was statistically significant(P=0.000).Conclusion In the treatment of inferior calyceal calculi ≤2cm,one-time electronic soft ureteroscopic lithotripsis has similar operation duration and long-term stone clearance rate as mini-PCNL,and has the advantage of effectively reducing intraoperative blood loss,reducing the incidence of postoperative complications such as fever,bleeding and pain,and significantly shortening the average hospital stay of patients.