Clinical Study Of Minimally Invasive Percutaneous Nephrolithotomy And Flexible Ureteroscopy Lithotripsy For Upper Ureteral Calculi

Objective To evaluate the outcomes of minimally invasive percutaneous nephrolithotomy (mPCNL) and flexible ureteroscopy lithotripsy (F-URL) for upper ureteral calculi.Methods From January2011to March2014,120patients with upper ureteral calculi (diameter>1.5) were include.These patients were divided into two groups. Minimally invasive percutaneous nephrolithotomy (mPCNL) was performed in70patients and flexible ureteroscopy lithotripsy (F-URL) was performed in50patients.All these patients include light and moderate hydronephrosis group (68cases),severe hydronephrosis group (42cases). The following parameters of F-URL were compared with the mPCNL:postoperative hospitalization time,complications,one-time stone clearance rate,blood loss (the decline of hemoglobin before and after operation),and operative time.Result In group of the F-URL,one-time stone clearance rate was94%,and in group of the mPCNL it was97.1%(P>0.05).In group of the F-URL,postoperative hospitalization time was3.1±0.9days,4.6±1.9days in light and moderate,severe hydronephrosis group,respectively;blood loss was3.4±2.4g/1,8.0±4.2g/l,respectively;operative time was65min±11min,80min±17min, respectively.In group of the mPCNL, postoperative hospitalization time was6.0±2.2days,5.9±1.8days in light and moderate,severe hydronephrosis group,respectively;blood loss was11.5±7.0g/1,9.0±4.4g/l,respectively;operative time was73min±9min,65min±7min, respectively. Statistical difference in postoperative hospitalization time was observed between the two groups.In the light and moderate hydronephrosis groups,There were significant differences in blood loss and operative time.In the severe hydronephrosis group,there was no statistical difference in blood loss,but, there was statistically significant difference in operative time. Conclusion (1) Both F-URL and mPCNL are effective and safe treatment for upper ureteral calculi (diameter>1.5cm).(2) For those patients with light and moderate hydronephrosis F-URL is a safe and effective treatment.(3) For those patients with sever hydronephrosis,mPCNL is one of the available choices.