Comparison of the efficacy and safety of micro channel percutaneous nephrolithotomy and ret-rograde intrarenal surgery in the treatment of upper urinary calculi
Objective To analyze and compare the efficacy and safety of micro channel percu-taneous nephrolithotomy(MPCNL)and retrograde intrarenal surgery(RIRS)in the treatment of 2.0-3.0 cm upper urinary calculi.Methods From February 2018 to October 2021,72 patients with 2.0-3.0 cm upper urinary calculi diagnosed in our hospital were collected retrospectively and divided into two groups:The MPCNL group was given MPCNL,and the RIRS group was given RIRS treatment,with 36 cases in each group.The patient's hospitalization related indicators,the stone clearance rate and serum inflammatory indicators at 1 week,1 month,and 3 months,serum inflammatory markers af-ter surgery[tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),IL-6,IL-4 and IL-2],visual analogue scale(VAS),renal function(serum creatinine and urea nitrogen),surgery related complica-tions and second-stage surgery were recorded and compared within two groups.Results Compared with the MPCNL group,the intraoperative blood loss,surgery time,hospital stay,creatinine,urea ni-trogen in the RIRS group were reduced,and hospitalization expenses were significantly increased(all P＜0.05).Compared with the MPCNL group,the stone clearance rate of the RIRS group was lower at 1 week and 1 month after the surgery(x2=4.126、5.258,all P＜0.05).Three days after surgery,compared with the MPCNL group,the TNF-α,IL-6,IL-2 were all increased in the RIRS group,IL-10,IL-4,VAS were all decreased in the RIRS group(all P＜0.05).There was no significant difference in complications between two groups(x2=0.127,P=0.722).Compared with the MPCNL group,the RIRS group had more second-stage surgery(x2=4.235,P=0.040).Conclusions Both MPCNL and RIRS can be used to treat 2.0-3.0 cm upper urinary calculi.But each has advantages and disadvanta-ges.The cost of MPCNL is lower,but the amount of intraoperative blood loss is higher,and the in-flammatory reaction is lower.The postoperative blood loss of RIRS is lower,the inflammatory response is low,but the cost is higher and the probability of second-stage surgery are higher.It is recommended that the treatment plan for upper urinary calculi should be individualized according to the patient's con-dition and willingness.
万方数据
维普
