Is flexible ureteroscopic lithotripsy combined with flexible negative-pressure sheath an appropriate treatment option for patients with 3-4 cm renal calculi?
10.3969/j.issn.1009-8291.2025.09.003
- VernacularTitle:输尿管软镜碎石术联合可弯曲负压吸引鞘是否适用于治疗3～4cm肾结石?
- Author:
Xiangyu CHEN
1
;
Chancan LI
;
Zhe ZHU
;
Chang LU
Author Information
1. 蚌埠医科大学研究生院,安徽 蚌埠 233030;安徽省第二人民医院泌尿外科,安徽 合肥 230012
- Publication Type:Journal Article
- Keywords:
flexible ureteroscopic lithotripsy;
flexible negative-pressure sheath;
percutaneous nephrolithotomy;
3-4 cm renal calculi;
stone-free rate
- From:
Journal of Modern Urology
2025;30(9):739-743
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy and safety of flexible ureteroscopic lithotripsy(FURL)combined with flexible negative-pressure sheath in treating patients with 3-4 cm renal calculi with CT value＜1100 Hu,and to identify a safe and effective treatment option for patients with such calculi.Methods A retrospective analysis was conducted on the clinical data of 95 patients undergoing surgical treatment at the Department of Urology,the Second People's Hospital of Anhui Province during Jun.2022 and May 2024.The patients were divided into two groups,including 42 in the FURL with flexible negative-pressure sheath group(FURL group),and 53 in the percutaneous nephrolithotomy(PCNL)group.General data,perioperative indicators,and complication rates were compared between the two groups.Results There were no statistically significant differences between the FURL group and PCNL group in stone-free rate(SFR)3 days postoperatively(83.3％vs.88.7％),1 month postoperatively(95.2％vs.92.5％),and 3 months postoperatively(97.6％vs.94.3％),as well as operation time[(77.65±9.05)min vs.(79.10±8.14)min](P＞0.05).The FURL group had shorter hospital stay[(5.98±1.12)days vs.(9.38±1.57)days],lower decrease in hemoglobin level[(3.17±0.85)g/L vs.(4.98±1.72)g/L],lower visual analog scale(V AS)score on postoperative day 1[(2.60±0.63)vs.(3.77±1.09)]and day 3[(2.29±0.99)vs.(2.70±0.89)],lower postoperative white blood cell count[(7.05±1.66)× 109 cells/L vs.(11.24±2.90)× 109 cells/L],lower C-reactive protein level[(25.73±7.57)ng/L vs.(31.14±5.53)ng/L],lower blood urea nitrogen level[(6.12±1.43)mmol/L vs.(9.85±3.07)mmol/L],and lower serum creatinine level[(84.48±11.57)μmol/L vs.(114.43±21.48)μmol/L](all P＜0.001).The total incidence of complications was also lower in the FURL group(4.8％vs.18.9％,P＜0.05).Conclusion FURL combined with flexible negative-pressure sheath can achieve comparable SFR as PCNL without extending operation time,and it can shorten hospital stay,reduce intraoperative blood loss,have little impact on renal function,reduce inflammatory response and decrease the incidence of complications.
