Minimally Invasive Percutaneous Nephrolithotomy And Flexible Ureteroscope On The Clinical Efficacy Of Treatment Of Upper Ureteral Calculi

Objective:To compare minimally invasive percutaneous nephrolithotomy(mPCNL)and flexible ureteroscope(FURS)on the clinical efficacy of treatment of upper ureteral calculi.Methods:40 patients with single calculi in the proximal ureter were selected as the object of study from hospital between June,2015 and January,2016.These cases included the calculi(0.7-1.0cm)which failed in the treatment of ESWL and the calculi diameter were between 1.0cm and 3.0cm.According to the order of admission,the patients were divided into two groups.One group which had 24 cases were treated with minimally percutaneous nephrolithotomy holmium laser lithotripsy and the other group which had 16 cases were treated with flexible ureteroscope holmium laser lithotripsy.The cases of two groups of age,the size of calculi,the degree of hydronephrosis,operation time,postoperative hospital stay,surgical complications,and calculi residual rate were compared.Results:In comparion of the percutaneous nephrolithotomy group and flexible ureteroscope group,the average operation time was 77.63±13.90(min)for minimally invasive percutaneous nephrolithotomy,and 75.94±28.71(min)for flexible ureteroscope.There was no significant difference(P>0.05).The postoperatively average hospitalization time was 8.83±3.02(d)for minimally invasive percutaneous nephrolithotomy,and 4.38±1.09(d)for flexible ureteroscope.The hospitalization time of flexible ureteroscope group was significantly lower than that of minimally invasive percutaneous nephrolithotomy,and the difference had statistical significance(P<0.01).The first stage of operation of two groups were successful,and nobody failen in puncturing and setting flexible ureteroscope.Minimally invasive percutaneous nephrolithotomy had 8.3%(2/24)residual stones,and flexible ureteroscope group had 18.8%(3/16)residual stone.Conclusion:The flexible ureteroscope lithotripsy was more simple,more safe,less trauma and less suffering than minimally invasive percutaneous nephrolithotomy in treating proximal ureteral calculi.But the patients had to have extra hospitalization and have the risk of complication of double J tube.So we hold the opinion that we should choose operation method according to the actual situation of patients in clinic.