A Comparison Of 2 Percutaneous Nephrolithotomy Techniques For The Treatment Of Kidney Stones Of Sizes?2cm: Microperc Vs PCNL

Objective:To compare the clinical efficacy and safety of micro percutaneous nephrolithotomy(Microperc)with PCNL in the treatment of renal stones of size ?2cm.Method:From April 2016 to October 2018,our hospital underwent ultrasound-guided percutaneous nephrolithotomy micro PCNL(Microperc)(F4.8)lithotripsy and standard channel(F20~24)percutaneous nephrolithotomy.There were 43 cases of calculus stones who underwet Microperc(group1)or the PCNL(group2)for the renal stones of sizes ?2cm.All the 43 cases were treated with ESWL.But,the stones were not successfully broken.There were 20 cases of Microperc,including 15 cases of males and 5 cases of females.The mean age was 54.05±10.55 years old.The diameter of stones was 18.35 ±1.88 mm,which measured according to urinary CT.The number of standard access percutaneous nephrolithotomy(group2)for stone removal was 23 cases,including 16 male and 7 female,which men age was 53.83 ± 7.01 years.The stone diameter was 17.30 ± 2.39 mm measured by urinary CT.We evaluate the clinical efficacy of the two methods by the stone-free rate.The operation time,the proportion of postoperative body temperature exceeding 38.5 ?,the postoperative analgesic application ratio,postoperative hemoglobin reduction,blood transfusion rate,postoperative bed time,postoperative hospitalization days,and the hospitalization expenses were to evaluate the safety of the two methods.Result:Puncture channels were successfully established in both groups,and single-stage percutaneous nephrolithotomy was performed in the first phase.Among them,20 patients underwent micro percutaneous nephrolithotomy with the all-seeing needle(F4.8)and 23 patients underwent percutaneous nephrolithotomy(F24).We evaluated the clinical efficacy of the two methods by stone clearance rate.The safety of the two methods was evaluated according to the proportion of antipyretic drugs used inpostoperative fever,the proportion of painkillers used after operation,the decrease of hemoglobin before and after operation,the time of getting out of bed after operation and the time of discharge after operation.The data of Microperc and PCNL were as follows: the stone-free rate: 90%(18/20)vs 95.7%(22/23),P>0.05;operation time:46.05±5.31 min vs 34.04±6.64 min,P<0.05;postoperative body temperature?38.5 ?,the proportion of antipyretic drugs applied: 20%(4/20)vs 8.7%(2/23),P>0.05;postoperative painkillers(Tramadol)application ratio: 10%(2/20)vs 39.13%(9/23),P<0.05;postoperative hemoglobin reduction: 8.45 ± 7.52g/L vs 13.70 ±5.94g/L,P <0.05;blood transfusion rate: 5%(1/20)vs 8.7%(2/23),P>0.05;postoperative bed rest time: 1.95±0.97 days vs 3.26±0.85 days,P<0.01;hospitalization days:4.55±0.92 days vs 6.26±1.26 days,P<0.01;hospitalization costs:33577.22±2346.04 yuan vs 21151.82±1726.07 yuan,P<0.01.Conclusion:The clinical efficacy of Microperc was similar to that of PCNL,but the trauma of Microperc was less.The postoperative bed rest time and postoperative hospital stay of Microperc were significantly shorter than those of PCNL,and the safety of Microperc was higher than that of PCNL.However,the cost of hospitalization of Microperc was higher than that of PCNL.