Clinical Efficacy Comparison Of Transurethral Flexible Ureteroscopy And Percutaneous Nephroscopy In The Treatment Of Renal Calculi

Objective :To compare the clinical effects of transurethral flexible ureteroscopic lithotripsy(FURL)and percutaneous nephrolithotomy(PCNL)in the treatment of kidney stones with a diameter of 2-3 cm.Methods: From January 2016 to January 2019,52 cases of renal calculi 2-3 cm in diameter were treated with FURL and PCNL respectively in the urology department of the First Affiliated Hospital of Bengbu Medical College.The stone clearance rate,operation time,incidence of complications and hospitalization time were compared between the two groups.Results:There was no significant difference between the two groups in sex,age and the maximum diameter of stones(P > 0.05).It can be concluded that there was no significant difference in sex,age and the maximum diameter of stones between the two groups,and there was comparability.In FURL group,52 patients were successfully operated with stone clearance rate of 80.8%(42/52);the operation time was 62-135 minutes,with an average of 96.7 minutes;4 patients had high fever,the rest had no special abnormalities,and the incidence of complications was 7.7%(4/52);the hospital stay was 3-12 days,with an average of 4 days.In PCNL group,1 case was converted to open operation to stop bleeding and cut stone.After transfusion,the other 51 cases were discharged smoothly.The stone clearance rate was 92.2%(47/51);the operation time was 42-120 minutes,with an average of 66.5 minutes;1 case had more bleeding during operation,9 cases had high fever after operation,and 4 cases had secondary bleeding(red eggs).The complications were 26.9%(14/52)and the hospital stay was 5-15 days(average 9 days).Statistical analysis showed that there was no significant difference in stone clearance between the two groups(P > 0.05).There were significant differences in operation time,complication rate and hospital stay between the two groups(P < 0.05).Conclusion:For kidney stones with diameter of 2-3 cm or more,PCNL stone clearance rate is high and operation time is short,which is still the first choice,but its trauma is large,easy to bleed and infection should still arouse our great attention;FURL also has a high stone clearance rate,while less trauma,low incidence of complications such as bleeding infection,fast recovery after operation,but the operation time is longer?It is also an option for patients who are difficult to undergo percutaneous puncture and fistula,as well as doctors who are experienced in flexible ureteroscopic surgery.