Super-mini Percutaneous Nephroscope Versus Flexible Ureteroscope In Lithotripsies For 1.5-2.5cm Kidney Stones:A Layered Analysis Based On Stone Sizes

Objective: To compare super-mini percutaneous nephrolithotomy(SMP)and flexible ureteroscopy lithotripsy(FURL)for the treatment of nephrolithiasis in different layers of stone sizes.Subjects and Methods: From September 2015 to September 2017,160 nephrolithiasis patients who underwent SMP or FURL in our center were retrospectively analyzed.All enrolled patients in this study were divided into two layers based on stone sizes: patients with stones 1.5-1.9cm,SMP group(n=30),FURL group(n=30);patients with stones 2.0-2.5cm,SMP group(n=50),FURL group(n=50).Results: For 1.5-1.9cm stones: SMP’s mean operative time was 50.13±12.84 min,FURL’s was 52.20 ±22.70 min,and there was no statistically significant difference(p>0.05).Hemoglobin drop level was less in FURL group than in SMP group(4.17±4.73 vs.7.33±4.97 g/L,p=0.007).There was no statistically significant difference between SMP and FURL group for the initial SFR and the SFR in one month after operation.FURL costs much more than SMP(8102.60±645.60 vs.5224.57±1167.23 yuan,p<0.001).For 2.0-2.5cm stones: Mean operative time was significantly less in SMP group than in FURL group(55.72 ± 16.83 vs.62.90 ± 23.82 min,p=0.042).Hemoglobin drop level was less in FURL group than in SMP group(6.64±6.23 vs.9.42±6.43 g/L,p=0.015).The initial SFR and the SFR in one month after operation in SMP group were significantly higher than in FURL group(88% vs.62%,p=0.003,94% vs.80%,p=0.037).SMP costs less than FURL(5432.44±1102.73 vs.8008.90±417.16 yuan,p<0.001).Conclusion: For patients with kidney stones of 1.5-1.9cm,FURL’s SFR is similar to that of SMP,while the surgical trauma is smaller.In terms of minimally invasive,FURL is recomended priority.Consider the cost of surgery,SMP is more economical.For stones 2.0-2.5cm,FURL can be selected only for the minimally invasive consideration,while SMP is better in terms of SFR and cost performance.