Flexible Ureteroscopy Combined With Holmium Laser Lithotripsy For The Treatment Of Renal Calculus

Objective: The study aimed to assess safety and efficacy of FURS for the treatment of renal calculus.Methods: A prospective randomized study was done from March 2014 to March 2015. 31 patients underwent FURS were included in the study. Patients were followed by KUB+IVP、urinary color ultrasound and CT to diagnose with renal stones. According to the long stone path and taking 20 mm as the boundary, > 20 mm was defined as a large stone group and ≤20mm was defined as a group of small stones. Assessed operative time、length of hospital stay after operation、stone-free rate and the complications of the two groups.Results: There were 18 cases in the small stones group. The postoperative complication rate was 16.7%. The median time of indwelling urinary catheter was 2 days and the median time of postoperative hospital stay was 2 days. There was one case of stone remnants with the stone-free rate was 94.4%.The operation time was 30-180 min, the average operation time was 93.7±44.7min. There were 13 cases in the large stone group. The postoperative complication rate was 15.4%. The median time of indwelling urinary catheter was 3 days and the median time of postoperative hospital stay was 3 days. There were 2 cases of stone remnant with the stone-free rate was 84.6%.The operation time was 60-300 min, the average operation time was 133.6±60.5min. There were no significant differences in postoperative complications,postoperative indwelling catheter time, hospitalization time and stone-free rate between the two groups. The operation time of the two groups was statistically different(P=0.043)and the size of the stones was significantly associated with surgical time(P <0.01).Conclusions: Flexible ureteroscopy combined with holmium laser lithotripsy for the treatment of > 20 mm renal calculus and ≤20mm renal calculus had similar clinical efficacy. Its stone-free rate, postoperative complications, postoperative indwelling catheter time, and postoperative hospital stayed roughly the same but the large stones needed a longer operation time.