Comparison Between Rigid Combined with Flexible Ureteroscopic Lithotripsy and Minimally Invasive Percutaneous Nephrolithotomy for Impacted Upper Ureteral Calculi
10.3969/j.issn.1009-6604.2017.11.003
- VernacularTitle:输尿管硬镜联合软镜碎石术与微创经皮肾镜取石术处理输尿管上段嵌顿结石的比较
- Author:
Tieqiu WU
1
;
Zhimin WANG
Author Information
1. 长沙市第一医院泌尿外科
- Keywords:
Ureteral calculi;
Percutaneous nephrolithotomy;
Ureteroscope lithotripsy;
Flexible ureteroscope
- From:
Chinese Journal of Minimally Invasive Surgery
2017;17(11):970-973
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety between rigid combined with flexible ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotomy ( MPCNL ) for impacted upper ureteral calculi . Methods We retrospectively analyzed 102 cases of impacted upper ureteral calculi treated in our hospital between June 2010 and April 2015.The patients were divided into two groups according to treatment methods: 54 cases underwent rigid combined with flexible ureteroscopic lithotripsy ( Combined group ) and 48 cases received MPCNL ( MPCNL group ) .The operation time , blood loss during operation , clearance rate of the stone, incidence of postoperative complications , and hospitalization time were statistically analyzed . Results All the patients tolerated operations without severe complications .The mean operation time of the Combined group was (87.9 ±21.6) min, which was significantly longer than that of the MPCNL group [(61.5 ±16.7) min, t=-6.795, P=0.000].The intraoperative blood loss in the MPCNL group was (52.8 ±9.6) ml, which was higher than that of the Combined group [(12.5 ±2.6) ml, t=29.644, P=0.000].The mean postoperative hospitalization time in the MPCNL group was (6.1 ±1.3) d, which was longer than that in the Combined group [(2.8 ±0.7) d, t=16.162, P=0.000].There was no significant difference in the incidence of postoperative complications between the two groups (χ2 =0.330, P=0.566).The stone clearance rates after one month postoperation were 95.7％(45/47) and 94.4％(51/54) in the MPCNL group and Combined group , but there was no signification difference between the two groups (χ2 =0.000, P=1.000). Conclusions Both rigid combined with flexible ureteroscopic lithotripsy and MPCNL are effective and safe for impacted upper ureteral calculi .Rigid combined with flexible ureteroscopic lithotripsy is a kind of natural orifice transluminal endoscopic surgery , which has no direct damage to the renal parenchyma with less bleeding and trauma , and shorter hospitalization time.
