Comparison Study Of Efficacy And Safety Between Standard Channel And Microchannel Percutaneous Nephrolithotomy In The Treatment Of Renal Calculi

Objective:To observe and compare the efficacy and safety of standard channel percutaneous nephrolithotomy and microchannel percutaneous nephrolithotomy in the treatment of patients with renal calculi.Methods:Retrospective analysis was performed on 92 patients with renal calculi who underwent percutaneous nephrolithotomy in the Second Department of Urology,First Hospital of Jilin University from December 2018 to December 2020.The patients were divided into standard channel percutaneous nephrolithotomy group(SPCNL group)and microchannel percutaneous nephrolithotomy group(MPCNL group)by being accepted the different surgical methods.The number of patients of SPCNL group is 50.Including 35 males and 15 females.Their age ranged from 28 to 71 years old.The average age is 51.96±11.02 years old.The number of patients of MPCNL group is 42,including 24 males and 18 females.Their age ranged from 28 to 76 years old.The average age is 52.62±12.25 years old.By comparing age,gender,BMI,indexes of preoperative examination results of patients in the two groups,the general information of patients between these two groups was analyzed to see if there was statistical difference.The efficacy and safety of the two surgical methods were assessed by comparing the duration of operation,intraoperative blood loss,renal function changes,time of hospital stay,time of postoperative bed stay,fever and other complications data between the two groups.SSPS 26.0 statistical software was used for data analysis.Mean and standard deviation(x ± s)were used to represent the measurement data conforming to the normal distribution curve,and t test was used to represent the measurement data not conforming to the normal distribution curve.M(P25-P75)was used to represent the measurement data,and the difference between groups was used to test the rank sum,counting data expressed in percentage(%),withχ2 test,P < 0.05 for the two groups of data difference was statistically significant.Results:Comparing general information such as age,gender,BMI and stone side of patients in the two groups,the differences between these two groups had no statistical significance.And the two group was meaningful to be compared.The average amount of intraoperative blood loss in SPCNL group was 158.26±35.84 ml.The mean amount of intraoperative blood loss in the MPCNL group was 103.05±24.57 ml.The average intraoperative blood loss in SPCNL group was higher than that in MPCNL group.P=0.048(P < 0.05),and the difference between the two groups was statistically significant.The duration of operation of SPCNL group was 72.10±14.52 min.The duration of operation of MPCNL group was 88.64±22.69 min,P=0.049(P < 0.05),the duration of operation of SPCNL group was shorter than that of MPCNL group,and the difference between the two groups was statistically significant.The P values of renal function change,time of hospital stay,stone free rate and other intraoperative and postoperative indexes were all greater than 0.05,and there was no statistical significance between the two groups.The time of postoperative bed stay of SPCNL group was 5.76±2.63 days,and that of MPCNL group was 4.86±1.42 days,P=0.012(P < 0.05).The difference in time of postoperative bed stay between the two groups was statistically significant.Among the complications,5 patients in the SPCNL group occurred fever after surgery,accounting for 10%;In MPCNL group,14 patients occurred fever after operation,accounting for 33.33%;P=0.006(P < 0.05)The incidence of postoperative fever in SPCNL group was lower than that in MPCNL group,and the difference between the two groups was statistically significant.The incidence of septic shock was lower in SPCNL group than in MPCNL group in terms of number and proportion,but the P value of the two groups was greater than 0.05,and the difference between the two groups was not statistically significant.In postoperative blood transfusion and renal artery interventional embolization,the number and proportion of SPCNL group were higher than that of MPCNL group,but the P values of the two groups were greater than 0.05,and the difference between the two groups was not statistically significant.Conclusion:1.In this study,both SPCNL and MPCNL showed good therapeutic effects in the treatment of kidney stones.2.We recommend SPCNL for patients with long operation time and high risk of infection(such as infectious stones,diabetes,etc.).3.For patients at high risk of bleeding,we recommend MPCNL.