Clinical Study Of Mini-percutaneous Nephrolithotomy And Flexible Ureteroscopy In The Treatment Of Complex Renal Calculus

Objectives:To investigate the clinical efficacy of complex renal calculus with the therapy of the minimally invasive percutaneous nephrolithotomy combined pneumatic device and electronic ureteroscopy holmium laser lithotripsy,and meanwhile evaluate safety and feasibility of this treatment.Methods:To analyze the clinical data of 58 patients who were diagnosed as complicated kidney stones according to clinical manifestation and auxiliary examinations retrospectively,from October 2015 to January 2018 in China-Japan Union hospital of Jilin University.All patients signed surgery informed consent.28 of 58 patients were treated with simple standard-channel percutaneous nephrolithotomy and defined as the control group,while 30 of 58 patients adopted the therapy of minimally invasive percutaneous nephrolithotomy combined with electronic ureteroscopy and defined as the observation group(n=30).There were no statistical differences in clinical information like age distribution,gender distribution and stone diameter on the basis of statistical analysis.The clinical information in each group,such as primary stone clearance rate,operating time,postoperative hospital stay,postoperative hemoglobin variation and the incidence of complications should be recorded and analyzed the data difference between these groups.Results:The primary stone clearance rate was 93.3%(28/30)in the observation group and 71.4%(20/28)in the control group,significant difference existed in the two groups(p <0.05).The mean operative time was 93.37 ± 17.17 min in the observation group and 74.75 ± 12.75 min in the control group,statistical difference could be observed between the two groups(p <0.01).The average postoperative hospital stay was 7.3±1.0 days in the observation group and 8.9±1.1 days in the control group.significant difference existed in the two groups(p<0.01).The mean hemoglobin variation in the observation group was 7.27 ± 3.45 g / L and 8.71 ± 4.28g/L in the control group,no statistically significant was observed(p>0.05).The incidence of postoperative complications was 30%(9/30)in the observation group and 32.1%(9/28)in the control group,no statistically significant was observed(p> 0.05).Conclusion:The treatment of complex renal calculus with minimally invasive percutaneous nephrolithotomy combined with ureteroscopy has the advantages of high stone clearance rate and rapid recovery.It is a safe and efficient surgical method which deserves clinical application.