Clinical Efficacy Analysis Of Percutaneous Nephrolithotripsy Versus Flexible Ureteroscopic Lithotripsy In The Treatment Of Complex Renal Stones

Objective:To investigate the clinical efficacy of Percutaneous nephrolithotomy(PCNL)compared with Flexible ureteroscopic lithotripsy(FURL)in the treatment of complex renal stones.Methods:The clinical data of 182 patients with complicated renal stones treated by percutaneous nephrolithotripsy or soft ureteral lithotripsy were collected from January 2020 to December 2021 in The Affiliated Chongqing University Three Gorges Hospital.Spss25.0 was used to statistically analyze the clinical data of the two groups and compare the clinical efficacy of the two groups in the treatment of complex kidney stones.Results:The operation time in PCNL group was shorter than that in furl group(57.17±15.22min vs 88.521±17.78min,P<0.05),The one-time stone clearance rate was higher[95/107(88.8%)vs 57/75(76.0%),P<0.05].However,the postoperative hospital stay in PCNL group was longer than that in furl group(6.02±2.15days vs 2.73±0.86days,P<0.05);The mean value of hemoglobin concentration decreased more after operation(15.85±5.32g/L vs 8.43±6.35g/L,P<0.05);The intraoperative blood output was more(27.69±17.45ml vs 8.81±4.42ml,P<0.05);The incidence of postoperative complications was higher[9/107(8.4%)vs 1/75(1.3%),P<0.05].There was no significant difference between the two groups in general data(age,gender,left and right stones,stone diameter),total hospitalization expenses,changes of serum creatinine before and after operation,P>0.05.Conclusions:In the treatment of patients with complicated kidney stones included in this study,both PCNL and FURL have achieved good efficacy,and the two treatment measures have their own advantages and disadvantages.PCNL should be the first choice for the treatment of most complex kidney stones,and its one-time stone clearance rate is high;For complicated kidney stones with high surgical risk,such as solitary kidney,FURL should be preferred,which has higher reliability and safety;PCNL should be selected to improve the one-time stone clearance rate if the included angle between renal pelvis and renal calyces is less than 30°.