Comparison Of Staged Retrograde Flexible Ureteroscope Lithotripsy And Percutaneous Nephrolithotomy In The Treatment Of 3-4cm Diameter Kidney Stones

Objective:To compare the safety and effectiveness of staged flexible ureteroscope lithotripsy(FURL)and percutaneous nephrolithotomy(PCNL)in the treatment of 3-4cm kidney stones.Method:Firstly,the inclusion criteria for patients with kidney stones in this study were formulated.From November 2020 to September 2022,patients with kidneys stones in the Department of Urology,Bethune Third Hospital of Jilin University were divided into two groups and treated with two different surgical methods.The experimental group underwent flexible ureteroscope lithotripsy and the control group underwent percutaneous nephrolithotomy General data of patients and surgery-related data were collected,including patient gender,age,stone size,stone number,stone location,preoperative white blood cells,preoperative creatinine value,preoperative urinary white blood cells,preoperative hemoglobin.Surgical success rate,including stone removal rate,operation time,total postoperative hospital stay,postoperative complication rate,hemoglobin reduction,creatinine value increase,and surgical cost.SPSS26.0 statistical software was used for data analysis.The mean and standard deviation of normal distribution data were expressed as(X±S),and the median(lower quartile ～ upper quartile)of non-normal distribution data were expressed as.The general data of patients and surgery-related data were compared by t test,z test or chisquare test.P<0.05 was considered statistically significant.Results:There were no statistical differences in surgical success rate,stone clearance rate and postoperative complications(P>0.05),but there were statistical differences in operation time,total postoperative hospital stay,postoperative hemoglobin changes,creatinine changes and surgical costs(P<0.05).Conclusion:Both staging ureteroscope lithotripsy and percutaneous nephrolithotomy are effective and safe in the management of 3-4cm kidney stones.There were no significant differences in surgical success rate,stone clearance rate and postoperative complications.The time of percutaneous nephrolithotomy was shorter,and the cost was lower.Staging flexible ureteroscope had lower hemoglobin decline and less blood loss.The increase of creatinine in staging ureteroscope group was lower than that in percutaneous nephrolithotomy group.For 3-4cm kidney stones,percutaneous nephrolithotomy and staging ureteroscopy are both good surgical methods,with advantages and disadvantages.