Comparative analysis of the efficacy of flexible ureteroscopic lithotripsy and micro-channel percutaneous nephrolithotomy in the treatment of kidney stones in the elderly
Objective To investigate the differences in effects between flexible ureteroscopic lithotripsy(FUL)and micro-channel percutaneous nephrolithotomy(MPCNL)in the treatment of elderly patients with renal stones.Methods One hundred and eighteen elderly patients with renal stones in our hospital were selected.The patients were divided into a FUL group(n=60)and a MPCNL group(n=58)by using random number table method.The FUL group received FUL treatment while the MPCNL group was given MPCNL treatment.Perioperative indicators such as decreased hemoglobin(Hb)level,lithotripsy time,surgical time and hospital stay,stone clearance rate,pain degree estimated by Visual Analogue Score(VAS),renal function such as urine creatinine(UCr),blood uric acid(BUA)and blood urea nitrogen(BUN),total incidence rate of complications and recurrence rate of renal stones were compared between the two groups.Results The Hb decline level and hospital stay in the FUL group were significantly lower or shorter than those in the MPCNL group(P＜0.05).The lithotripsy time and surgical time were significantly longer in the FUL group than those in the MPCNL group(P＜0.05).There was no significant difference in the stone clearance rate between the two groups(P＞0.05).Compared with the MPCNL group,the VAS scores of patients at 1 hour,5,12 and 24 hours after surgery were markedly lower in the FUL group(P＜0.05).The BUN level in both groups after 3 days of surgery was not significantly different from that before surgery(P＞0.05).However,the level of UCr was significantly enhanced(P＜0.05)while the level of BUA was significantly reduced after 3 days of surgery when compared to before surgery(P＜0.05).However,there was no significant difference in the levels of UCr and BUA between the two groups(P＞0.05).There was no significant difference in the total incidence rate of peri-operative and postoperative complications during perioperative period and after surgery(P＞0.05).The difference in the recurrence rate of renal stones was not evident within 6 months after surgery between the two groups(P＞0.05).Conclusions FUL and MPCNL have similar efficacy in the treatment of elderly patients with renal stones,However,FUL has the advantages of smaller trauma and quicker postoperative recovery.Therefore,it can be used as a preferred option in clinical practice.
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