Impact of Various Lithotripsy Techniques on Stone Escape and Renal Functions in Patients with Upper Urinary Tract Stones
Objective To explore the impact of different lithotripsy techniques on stone escape and renal functions in patients with upper urinary tract stones for the sake of providing data support for the clinical selection of surgical procedures.Methods A retrospective analysis was conducted on the clinical data of 90 patients with upper urinary tract stones treated between Oct.2016 and Jan.2021.These patients were categorized into two groups by types of treatment procedure:a flexible ureteroscopic lithotripsy(FURL)group(n=40)and a mini-percutaneous nephrolithotomy(MPCNL)group(n=50).While the patients in the FURL group being given FURL treatment,those in the MPCNL group experienced the MPCNL treatment.The power of lithotripsy,operation duration,stone escape during the operation and hospitalization time for the patients of each group were recorded.The preoperative and 1-day postoperative hemoglobin and renal function indicators,including serum creatinine(Scr)and blood urea nitrogen(BUN)levels,were measured respectively.The stone clearance and complications were detected one week and two months after the surgery respectively.Results The stone escape rate during the operation in the FURL group and the MPCNL group was 7.50％and 4.00％respectively,and the difference between two groups was not significant(P＞0.05).The stone clearance rate in the FURL group was lower than that in the MPCNL group one week after the surgery(P＜0.05).There was no significant difference in the stone clearance rate between the two groups 2 months after the surgery(P＞0.05).The operation time in the FURL group was longer than that in the MPCNL group,the hospitalization time shorter than that in the control group,and the postoperative hemoglobin decrease lower than that in the MPCNL group(P＜0.05).The levels of Scr and BUN in the FURL group were lower than those in the MPCNL group 1 day after the surgery(P＜0.05).The incidence of postoperative complications in the FURL group and the MPCNL group was 10.0％and 20.0％respectively,and the difference was not significant(P＞0.05).Conclusions Both FURL and MPCNL are effective surgical procedures for treating upper urinary tract stones,and there is no significant difference in stone escape between the two procedures.However,FURL will cause less body damage,reduce the impact on renal functions and result in faster postoperative recovery and shorter hospitalization time.
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