Comparison Of Flexible Ureteroscopy And Percutaneous Nephrolithotomy For2to3cm Pelvic Stones:a Randomized Controlled Study

Objective:To compare the efficacy, safety and cost of flexible ureteroscopy(FURS) and percutaneous nephrolithotomy(PCNL) in the treatment of2-3cm pelvic stones.Methods:A total of100patients with2-3cm pelvic stones were enrolled in this study treated in Sir Run Run Shaw hospital from March2011to February2014. The patients were randomly divided into trial group and control group.50patients were treated with flexible ureteroscopy as trial group and50patients were treated with percutaneous nephrolithotomy as control group. We compare the stone-free rate, operative time, amount of bleeding during operation, blood transfusion percentage, preoperative and postoperative hemoglobin concentrations and CRP, analgesia drug usage, incidences of complications, hospitalization time after operation, total cost. Results:The amount of bleeding during operation of FURS group and PCNL group were respectively (15.5±1.6)ml and (86.7±13.1)min; pre-&post-operative hemoglobin concentrations were (0.9±0.1)g/L and (1.3±0.2)g/L; pre-&post-operative C-reactive protein (CRP) were (3.7±1.1) mg/L and (18.7±5.4) mg/L; analgesia drug usage perception were12%(6/50) and34%(17/50); hospitalization time after operation were (2.7±0.2)d and (6.0±0.3)d; incidences of complications(Clvien II) were4%(2/50) and12%(6/50); total cost were (23.67±0.61) thousand yuan and(27.70±0.81)thousand yuan. They all had a significant difference (P＜0.05). The stone-free rate(≤4mm) were92%(46/50) and94%(47/50); operative time were (83.1±4.4) min and (97.3±5.9)min. They all had a insignificant difference(P>0.05). Flexible ureteroscopy group is better than percutaneous nephrolithotomy group with respect to amount of bleeding during operation, blood transfusion percentage, preoperative and postoperative hemoglobin concentrations and CRP, hospitalization time after operation, incidences of complications perception, total cost. There were no obvious difference between Flexible ureteroscopy group and nephrolithotomy group in stone-free rate, operative time.Conclusion:Compared with PCNL, Flexible ureteroscopy has the same effect in stone-free rate, and takes the advantages of slighter damage, less bleeding, lower risk of complications,more speedy recovery, less cost in treating the2-3cm pelvic stone. Therefore, Flexible ureteroscopy can be one of the main approaches in treating2-3cm pelvic stone.