Analysis of the efficacy and safety of ureteroscopic holmium laser lithotripsy combined with microchannel percutaneous nephrolithotomy in treating upper urinary tract calculus
- VernacularTitle:输尿管软镜铥激光碎石术联合微通道经皮肾镜取石术治疗上尿路结石的临床疗效及安全性分析
- Author:
Liwei JING
1
;
Xin GU
1
;
Andi WANG
1
;
Baoling ZHANG
1
Author Information
- Publication Type:Journal Article
- Keywords: upper urinary tract calculus; ureteroscopic holmium laser lithotripsy; microchannel percutaneous nephrolithotomy(mPCNL)
- From: China Journal of Endoscopy 2025;31(6):78-84
- CountryChina
- Language:Chinese
- Abstract: Objective To evaluate the efficacy and safety of combining ureteroscopic holmium laser lithotripsy with microchannel percutaneous nephrolithotomy(mPCNL)in the treatment of upper urinary tract calculus.Methods From September 2020 to September 2023,300 patients diagnosed with upper urinary tract calculus were randomly divided into control group 1,control group 2,and the combined group by random number table method,100 patients in each.Control group 1 received treatment via ureteroscopic holmium laser lithotripsy,control group 2 underwent mPCNL,while the combined group was treated with a combination of ureteroscopic holmium laser lithotripsy and mPCNL.The perioperative indicators,serum inflammatory factor levels,pain scores,and incidence of complications were compared among the three groups.Results The stone clearance rate of the combined group was higher than that of control group 1 and control group 2,the surgical time was longer than that of control group 1 and control group 2,and the hospitalization time was shorter than that of control group 1 and control group 2,but the intraoperative bleeding volume of control group 1 was less than that of combined group and control group 2,the differences were statistically significant(P<0.05).Compared with before surgery,the levels of tumor necrosis factor-α(TNF-α)in three groups was increased 1 h after surgery;Compared with 1 h after surgery,the levels of TNF-α in three groups were decreased at 12 and 24 h after surgery,the differences were statistically significant(P<0.05).The procalcitonin(PCT)levels of the three groups at 1 and 12 h after the operation were significantly higher than those before the operation.The PCT level at 24 h after the operation was significantly lower than that at 12 h after the operation,but significantly higher than that before the operation and 1 h after the operation in three groups,the differences were statistically significant(P<0.05).At 1,12,and 24 h after surgery,the visual analogue scale(VAS)scores of the three groups decreased sequentially,and the control group 1 was lower than that of combined group and control group 1,the difference was statistically significant(P<0.05).The total incidence of complications was no statistically obviously different among the three groups(P>0.05).Conclusion The ureteroscopic holmium laser lithotripsy combined with mPCNL for upper urinary tract calculus has a high stone clearance rate,fast postoperative recovery,and does not increase the incidence of complications.
