| Objective: To analyze the clinical information of patients with both renal single stones or upper ureter single stones(diameter<2.5cm)and type 2 diabetes mellitus,and to study the effect of type II diabetes on the efficacy and safety of two surgical methods.Methods:A retrospective study on 257 cases of upper urinary calculi admitted to the Department of Urology from January 2016 to December 2018 was conducted,of which,65 patients combined with type 2 diabetes were treated with ureteroscopic lithotripsy(group A),50 patients with type 2 diabetes received microchannel percutaneous nephrolithotomy(group B),64 patients without type 2 diabetes underwent ureteroscopic lithotripsy(Group C)and 78 patients without type 2 diabetes took microchannel percutaneous nephrolithotomy(group D).Comparisons between group A and group B,group A and group C,group B and group D were made in regards to preoperative clinical data,fasting blood glucose,calculus CT value,single surgery stone clearance rate,surgicalcomplications,hemoglobin decrease,preoperative and surgery between or after hospitalization time.Results:(1)The difference of postoperative length of stay(4.40±2.34vs7.42±2.30)days,operation time(62.32±19.76 vs73.24±14.08)mins,hemoglobin decrease(3.98±4.09)g/Lvs(9.90±2.99)g/L,showed statistical significance(p<0.05).and after operation,the difference of analgesic drug use rate(9.23% vs 28.00%),and clavein grade I complication rate(10.77% vs26.00%)and stone-free-rate(SF R)(70.8% vs 90.0%)at the first reexamination between group A and group B was statistically significant(p<0.05);while the difference of postoperative infection rate,clavein grade II complication rate,SFR at the second reexamination between above mentioned two groups was not statistically significant(p>0.05).(2)The difference of time of operation(62.32±19.76vs77.64±19.30)mins between group A and group C exhibited statistical significance(p<0.05).however,The difference of postoperative length of stay and hemoglobin decrease between thsese two groups was not statistically significant(p>0.05),Moreover,the difference of the postoperative analgesic drug use rate,postoperative infection rate,clavein grade I complications rate,clavein grade II complications rate,SFR at the first and second follow-up exam between group A and group C showed no statistical significance(p>0.05).(3)The difference of postoperative hospital stay(7.42±2.30vs6.37±1.83)days between group B and group D was without statistical significance(p<0.05);however,The difference of the operating time,hemoglobin decreased between group B and group D was not statistically significant(p>0.05).For group B andgroup D,comparisons on the postoperative analgesic drug use rate,the postoperative infection rate,and the clavein grade I complications rate,clavein grade II complications rate,and the SFR at the first and second reexamination marked no significant difference(p>0.05).Conclusion:(1)type 2 diabetes did not affect the efficacy and safety of both surgical treatments,however,type 2 diabetes may did prolonged the postoperative hospital stay in the microchannel percutaneous nephrolithotomy.(2)flexible ureteroscopic lithotripsy and microchannel percutaneous nephrolithotomy are safe and effective surgical methods for treating patients with renal single stones or upper ureter single stones(diameter <2.5cm)with type 2diabetes,the former showed better safety and faster recovery.This makes flexible ureteroscopic lithotripsy a potential alternative to microchannel percutaneous nephrolithotomy in treating renal single stones or upper ureter single stones(diameter <2.5cm)complicated with type 2 diabetes. |
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