Effect Of Flexible Ureteroscopic Lithotripsy And Percutaneous Nephrolithotomy For The Treatment Of Upper Urinary Tract Calculi

AIM: To comparison the efficacy of flexible ureteroscopic Lithotripsy(FURL)and percutaneous nephrolithotomy(PCNL)in the treatment of upper urinary tract calculi,and to explore the application of S.T.O.N.E.nephrolithometry scoring systeam(S.T.O.N.E.score)in clinical FURL treatment.METHORDS: A total of 100 patients with complicated upper urinary tract calculi between October 2016 and December 2017 in Department of Urology,Fuling Central Hospital,Chongqing,were retrospective analyzed and divided into two groups: the FURL group,the PCNL group.Comparison of the operation time,postoperative hospital stay,complications,and stone-free rate(SFR)of the two surgical methods was for understanding the difference of the treatment effect between the two groups.Though the S.T.O.N.E.score to evaluate the complexity of the upper urinary tract calculi and according to the SFR and preoperative prediction comparison,to understand the clinical application of S.T.O.N.E.scoring system in clinical FURL treatment.RESULTS: The operative time(88.85±28.79 vs 77.60±24.31min),postoperative hospital stay(2.85±1.27 vs 6.86±2.25days)and postoperative complication rate(9.43% vs 25.53%)in FURL group and PCNL group were statistically significantly(P <0.05).The total stone SFR was 73.58%(39/53)in the FURL group and 85.11%(40/47)in the PCNL group,SFR with no significant difference(P> 0.05).According to the patients with 1~2cm stone accounted for 86.36%(19/22)in FURL group while 92.86%(13/14)in PCNL one,but without statistical difference between them(P>0.05).2 cm≤ Stone diameter <3 cm,77.27%(17/22)in FURL group and 80.95%(17/21)in PCNL group,the difference was not statistically significant(P>0.05).In 3 cm≤Stone diameter <4 cm,33.33%(3/9)in FURL group and 83.33%(10/12)in PCNL group,the difference was statistically significant(P <0.05).In this trial,32 patients in the FURL group and 27 patients in the PCNL group met the S.T.O.N.E.nephrolithometry scoring system standard.FURL group scored 5 to 11 points,PCNL group scored 6-11 points.In 6-8 points,FURL group SFR was 77.78%(14/18),PCNL group was 85.71%(18/21),the difference was not statistically significant(P> 0.05).CONCLUSION: 1.Patients with urinary tract stones less than 3 cm in diameter,FURL treatment is recommended.2.The S.T.O.N.E.score is more accurate in predicting the stone-free rate in patients with FURL treatment ≤ 8 points.