Clinical Effect And Health Economics Analysis Of FURL And SMP In The Treatment Of Calyx Calculi

Objective:The aim of this study was to evaluate the clinical efficacy of transurethral flexible ureterolithotripsy(FURL)and super-min percutaneous nephrolithotripsy(SMP)in the treatment of inferior calyces of kindey and to analyze the relative cost-effectiveness.Methods: A total of 218 patients with subrenal calyx calculi underwent surgical treatment from January 2019 to S by combined ureteral soft mirror holmium laser lithotripsis(FURL group).Sixty-six patients were treated with super-min channel percutaneous nephrolithotripsy(SMP group).A comparison of the FURL and SMP groups was made,with general information such as age,gender,stone side,body mass index,hypertension,diabetes,single and multiple stones,maximum stone diameter,operation time(minutes),postoperative hospital stay(days),and stone cleptember 2022 collected retrospectively.106 patients were treated,with a total rate(%)of postoperative complications,total cost of treatment(yuan),cost of antibiotics(yuan),and cost of related surgery(yuan)as well as a mean difference of hemoglobin before and after surgery(g/L),pain 24 hours after surgery(Visual Analogue Score,VAS)score,and total rate of postoperative complications(%).Results: The study revealed that the FURL cohort’s operation time was significantly greater than the SMP cohort’s(P=0.03),and their postoperative hemoglobin reduction was less than the SMP group’s(P=0.004).The mean VAS score 24 hours after surgery was significantly lower in the SMP group than in the FURL group(P<0.001).The FURL group experienced a significantly greater total cost of treatment than the SMP group(P=0.006),and the SMP group had a significantly higher stone clearance rate than the FURL group(P=0.015).The SMP cohort’s cost of antibiotics was significantly lower than that of the FURL cohort(P=0.018).No significant distinction in the mean cost of running was observed between the two sets(P=0.76).The SMP cohort’s complication rate was less than that of the FURL group,yet the disparity was not statistically noteworthy(P=0.329).Conclusion: Based on the comparison between SMP and FURL in terms of stone-free rates,operative times,scores 24 hours after surgery,incidence of postoperative complications,total cost of treatment,length of hospital stay after surgery,and postoperative antibacterial drug cost,stone-free rates and operative times were significantly higher in the SMP group than in the FURL group.Moreover,the SMP group had lower scores 24 hours after surgery,lower incidence of postoperative complications,and less total cost of treatment.However,the difference between the two groups was not statistically significant in terms of length of hospital stay after surgery.Although SMP technology is effective in reducing the incidence of complications,there is a potential risk of kidney injury which increases the probability of intraoperative and postoperative massive bleeding.In the case of postoperative bleeding,blood transfusion or specific renal artery embolization is required.In terms of health economics,the differences between the SMP group and the FURL group in total treatment cost and postoperative antibacterial drug cost were statistically significant,with the SMP group being significantly superior to the FURL group.