Comparison of ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotripsy in the treatment of impacted upper ureteral calculi

doi:10.3877/cma.j.issn.1674-3253.2018.04.004

Abstract

Abstract:

Objective

To analyze the clinical effects and safety of ureteroscopic lithotripsy (URL) and minimally invasive percutaneous nephrolithotripsy (MPCNL) in the treatment of impacted upper ureteral calculi by using EMS system.

Methods

Ninety-six patients with impacted upper ureteral calculi were enrolled in the study from January 2014 to December 2016 in our hospital, and were divided into URL group and MPCNL group, with 48 patients in each group. The clinical effects and safety of the two groups were compared.

Results

The operative time and the hospital stay in URL group were (54±8) min and (3.6±0.7)d, respectively, which were shorter than that in MPCNL group (59±9) min and (5.6±0.8) d, respectively (P<0.05). The success rate in MPCNL was 100%, while it was 75% in URL group (P<0.05). The stone clearance rate in the 3rd day and 1 month after URL operation were lower than that in MPCNL group (P<0.05). There was no significant difference in the incidence of ureteral perforation, blood transfusion, fever, and hematuria between the two groups (P>0.05).

Conclusion

MPCNL using EMS system is an efficacious and feasible approach for the treatment of impacted upper ureteral calculi due to the advantage of high calculi clearance rate, efficacy, and safety compared to URL.

Key words: Percutaneous nephrolithotripsy, Ureteroscopy, Ureteral calculi

Hao Zheng, Xiaoqing Zheng, Zhenyu Guo, Wenjie Cheng, Shuchang Huang, Xing Huang. Comparison of ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotripsy in the treatment of impacted upper ureteral calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(04): 228-231.

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References 12

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组别	例数	年龄（岁，±s）	性别（例）		侧别（例）		结石长径（mm，±s）
组别	例数	年龄（岁，±s）	男	女	左	右	结石长径（mm，±s）
MPCNL组	48	42.4±9.4	26	22	28	20	15.5±3.1
URL组	48	41.9±8.4	28	20	27	21	15.4±2.5
统计值		t=0.275	χ²=0.468		χ²=0.032		t=-0.255
P值		0.784	0.520		0.850		0.799

组别	例数	年龄（岁，±s）	性别（例）		侧别（例）		结石长径（mm，±s）
组别	例数	年龄（岁，±s）	男	女	左	右	结石长径（mm，±s）
MPCNL组	48	42.4±9.4	26	22	28	20	15.5±3.1
URL组	48	41.9±8.4	28	20	27	21	15.4±2.5
统计值		t=0.275	χ²=0.468		χ²=0.032		t=-0.255
P值		0.784	0.520		0.850		0.799

组别	例数	手术时间（min，±s）	中转开放（例）	并发症发生率[例（%）]	术后住院时间（d，±s）	一次碎石成功率[例（%）]	结石清除率[例（%）]
组别	例数	手术时间（min，±s）	中转开放（例）	并发症发生率[例（%）]	术后住院时间（d，±s）	一次碎石成功率[例（%）]	3 d	1月
MPCNL组	48	59±9	0	11(23)	5.6±0.8	48(100)	48(100)	48(100)
URL组	48	54±8	6	12(25)	3.6±0.7	36(75)0	23(48)0	38(79)0
统计值		t=-3.354	-	χ²=0.057	t=13.035	-	-	-
P值		<0.001	0.026	0.811	<0.001	<0.001	<0.001	0.001

组别	例数	手术时间（min，±s）	中转开放（例）	并发症发生率[例（%）]	术后住院时间（d，±s）	一次碎石成功率[例（%）]	结石清除率[例（%）]
组别	例数	手术时间（min，±s）	中转开放（例）	并发症发生率[例（%）]	术后住院时间（d，±s）	一次碎石成功率[例（%）]	3 d	1月
MPCNL组	48	59±9	0	11(23)	5.6±0.8	48(100)	48(100)	48(100)
URL组	48	54±8	6	12(25)	3.6±0.7	36(75)0	23(48)0	38(79)0
统计值		t=-3.354	-	χ²=0.057	t=13.035	-	-	-
P值		<0.001	0.026	0.811	<0.001	<0.001	<0.001	0.001

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