Comparative Study On The Treatment Of 2-4 Cm Renal Stones With CT Values ≤ 1200HU By MPCNL And FURL

Purposes:By comparing the surgical efficiency,surgical safety and postoperative complication rate of FURL and MPCNL groups,this research provides a reference for the selection of high-burden stone surgery.Methods:This study is a retrospective analysis that collected patients with2-4cm kidney stones with CT values ≤1200HU admitted to our hospital from January 2020 to December 2021.A total of 72 patients met the criteria,all of whom had completed the surgery in one stage and were performed by the same senior doctor.The patients were classified into Group A and Group B according to their different surgical methods,with36 patients in each group,the former had an operation of FURL(Flexible Ureteroscope Lithotripsy)and the latter had an operation of mPCNL(Minimallly Invasive Percutaneous Nephrolithotomy).Before surgery,the information of the two groups of patients(age,sex,stone size,stone CT value,ASA grades,etc.),operation time,visual analogue scale were recorded in detail according to our requirements.Also,we recorded the postoperative hospital stay,the effect of kidney function,the reduction of hemoglobin after operation,and the changes of infection index after operation.All the above indicators are compared and analyzed.Results:The data before operation(as mentioned above)did not differ significantly(P > 0.05).No significant difference was found between FURL group and mPCNL group in both short term and long term time(P > 0.05).There were no obvious differences in creatinine values and urea nitrogen before and after surgery in the two groups A and B,(P>0.05).There was no obvious difference in postoperative fever rate and infection indexes(leukocyte and procalcitonin)between patients A and B,(P>0.05).The number of days of postoperative hospital stay and postoperative VAS score of group A and group B were significantly lower than those in group B,and the difference was statistically significant,(P<0.05).The level of hemoglobin was reduced on the 1st day of operation,and the difference between Group A and Group B was obviously lower(P < 0.05).Conclusions:(1)Compared with MPCNL,FURL has the same operative efficacy,and FURL can also shorten the hospital stay,decrease the pain and discomfort after operation,and decrease the risk of hemorrhage.(2)For kidney stones of 2 to 4 cm with a CT value of ≤ 1200 HU,FURL is a safe,effective and more minimally invasive treatment option worth promoting.