A Clinical Study About Two Kinds Of Minimally Invasive Surgery For The Management Of 2?3cm Renal Calculus

Objective:To compare the outcomes of retrograde flexible ureteroscopy with control of renal pelvic pressure by automatic suction(RIRS-S)and Mini-percutaneous nephrolithotomy(MPCNL)for the treatment of renal calculus with a diameter of 2 to 3 cm.Methods:In total,91 patients with renal calculus which diameter was 2~3 cm were included in this study.Of these patients 46 underwent the retrograde flexible ureteroscopy with control of renal pelvic pressure by automatic suction and 45 underwent Mini-percutaneous nephrolithotomy.Operating time,complications,stone-free rate and postoperative hospital stay were compared between the groups.Results:The surgery success rate was 95.6%(44/46)to RIRS-S and 100%(45/45)to MPCNL,the different was not statistically significant.Three patient with postoperative fever and 2 cases of patients with postoperative pain in RIRS-S group,The incidence of complications was 10.8%.While 3 patient with postoperative fever,7 cases of patients with postoperative pain,3 patients needed a blood transfusion,1 case of renal artery bleeding patients with selective renal artery interventional embolization,the incidence of complications was 31.1% in MPCNL group,compare the total complications of two groups,the difference was statistically significan.The difference was not statistically significant for the average operation time and stone-breaking time(65.62±22.54 vs 56.23±28.35,P>0.05;23.26±15.12 vs 21.45±16.34,P>0.05).Postoperative hospital stay of RIRS-S group was shorter than MPCNL group,the difference was statistically significan(3.53±1.25 vs 6.54±2.36,P=0.000).There was no significant differences for stone-free rate(90.9% vs 95.5%,P>0.05).The average haemoglobin decline and Estimated blood loss to MPCNL group was Significantly higher than the RIRS-S group(1.37±1.85 vs 0.28±0.51,P=0.000;53.22±69.83 vs 8.36±10.21,P=0.000).Conclusions:For treatment of renal calculus with a diameter of 2 to 3 cm,both RIRS-S and MPCNL have similar success rates,but RIRS-S has the advantages of shorter postoperative hospital stay and fewer complications.