To compare clinical efficacy and safety between flexible ureteroscopic lithotripsy (F-URL) and microchannel percutaneous nephrolithotomy (MPCNL) for treatment of kidneys stones (2-3 cm).

From January 2015 and October 2017, 74 patients with kidneys stones (2-3 cm) in our hospitals were collected and divided into two groups, including 36 cases who underwent F-URL (observation group), and 38 cases underwent MPCNL (control group). The average operation time, the level of hemoglobin preoperative and postoperative, the average hospital stay, the stone-free rate, and the intraoperative complications were compared.

Operation time in F-URL group was obviously shorter than that in MPCNL group [(48.6±7.4) min vs (62.3±8.9) min, P<0.05], and the hemoglobin decrease level was also less than that in MPCNL group [(3.2±1.7) g/L vs (17.6±4.5) g/L, P<0.05]. Moreover, the hospital stay was shorter than that in MPCNL group [(4.1±1.8) d vs (6.8±2.3) d, P<0.05]. No statistical differences were found in stone clearance rate in both groups. The rate forblood transfusion in F-URL group was lower than that in MPCNL group (0.0% vs 7.9%, P<0.05). There were no differences in urinary tract infection, the stone street formation, phase II surgery or ESWL, and the complications in two groups (all P values >0.05).

For the treatment of 2-3 cm kidney stones, F-URL got the same stone clearance rate as the PCNL. Compared with PCNL, F-URL had lower postoperative bleeding, shorten hospitalization time, less surgical trauma, which was worth popularizing in clinic practice.