Comparative Study Of Flexible Ureteroscopy And Percutaneous Nephrolithotomy For Renal Calculi

Objective:To compare the efficacy and safety of flexible ureteroscopy and percutaneous nephrolithotomy for renal calculi.Methods:From March2012to December2013,89patients with renal calcul underwent operation,37patients were performed modular flexible ureteroscopy combined with holmiun laser lithotripsy (URL group),52patients were performed percutaneous nephrolithotripsy ultrasound combined with pneumatic lithotripsy (PCNL group).The postoperative mortality and calculi-free rate between both groups were compared.Results:The operation time of URL group was35-175min, and average time was58minutes.The amount of hemoglobin decrease was0-6g/L, and average amount was2g/L.4patients suffered from mild anemia after the operation, and3patients suffered from fever. The complication rate was18.9%(7/37).Success rate of operation was94.6%(35/37).The calculi-free rate was85.7%(30/35).The operation time of PCNL group was30-86min, and average time was46minutes.The amount of hemoglobin decrease was4-36g/L, and average amount was14g/L.21patients suffered from mild anemia after the operation, and3patients underwent blood transfusion because of moderate anemia, one of them underwent superselective renal artery embolization.4patients suffered from fever after the operation. The complication rate was53.8%(28/52).Success rate of operation was94.2%(49/52).The calculi-free rate was91.8%(45/49).Conclusion:The method of PCNL for renal calculi has the advantages of small damage, few complication and exact efficacy.But PCNL damaged renal parenchyma, would lead to hemorrhage, needed blood transfusion, even needed superselective renal artery embolization.The method of URL for renal calculi has the advantages of smaller damage, less complication, close to noninvasivc and exact efficacy.URL has unique advantages for complex renal calculi such as renal calculi complicated with scoliosis.