Comparative Efficacy Analysis Of Flexible Ureteroscopic Lithotripsy And Percutaneous Nephrolithotomy For Treatment Of Upper Urinary Tract Calculi

Objective:To observe the efficacy and safety of flexible ureteroscope lithtripsy(FURL)and percutaneous nephrolithotomy(PCNL)in the treatment of upper urinary tract calculi.Methods: 187 patients with upper urinary tract calculi who underwent surgical therapy between March 2014 to September 2015 in The First Affiliated Hospital of Wan Nan Medical College and Ma An Shan People’s Hospital were retrospective analyzed.The 187 patients were divided into group FURL(50 cases)and group PCNL(137 cases).FURL therapy and PCNL therapy were applied in these two group respectively.And,the difficulty of the treatment costs,total hospitalization time,postoperative hospitalization time,operative time,stone-free rate,hemoglobin decreased,hemostatic utilization indicator,blood transfusion rate,analgesic utilization indicator,operative complications,were recorded and compared.Results: Operation of both methods can complete the therapy successfully.The calculi diameter < 20 mm,method of group FURL have less operative time(T=-0.49,P<0.05)and less hemoglobin decreased when after operation(T=-3.422,P<0.05).The FURL group a similar upper urinary tract calculi clearance rate compare with PCNL group(χ2=0.16,P>0.05).However,the treatment costs,total hospitalization time,postoperative hospitalization time,hemostatic utilization indicator,blood transfusion rate,analgesic utilization indicator,operative complications,there’s no significant difference between two groups(P>0.05).The calculi diameter ≥ 20 mm,unlike expected,the FURL group still a similar upper urinary tract calculi clearance rate compare with PCNL group(χ2=2.37,P>0.05).The method of group FURL have less the total hospitalization time,postoperative hospitalization time(T1=-0.04,P<0.05;T2=6.85,P<0.05)and less hemoglobin decreased when after operation(T=2.32,P<0.05).And the group FURL have more rate of D-J tube shift and steinstrasse in ureter when after operation(χ21=10.95,P<0.05;χ22=13.56,P<0.05).However,the treatment costs,hemostatic utilization indicator,blood transfusion rate,analgesic utilization indicator,there’s no significant difference between two groups(P>0.05).Conclusion: Surgeries both FURL and PCNL are efficacy and safe for patients with upper urinary tract calculi.Compared with PCNL,FURL has a similar curative effect and an advantage in less hemorrhage,faster postoperative recovery.FURL can be used as an ideal choice of the upper urinary tract calculi whose maximum diameter less than 20 mm and above lumbar 4 plane.FURL also can be used for the upper urinary tract calculi whose maximum diameter more than 20 mm and above lumbar 4 plane to substitute PCNL.