Clinical efficacy of percutaneous nephrolithotomy combined with flexible ureteroscopy and holmium laser lithotripsy in the treatment of complicated renal calculi

Abstract

Objective To evaluate the clinical efficacy of percutaneous nephrolithotomy combined with flexible ureteroscopy and holmium laser lithotripsy in the treatment of complicated renal calculi. Methods Clinical data of 139 patients with complicated renal calculi from March 2013 to March 2019 in Miyun Teaching Hospital, Capital Medical University were retrospectively analyzed. There were 76 males and 63 females, the average was (47.9±3.1) years, aged from 27 to 75 years. The total patients were divided into control group (n=69) and treatment group (n=70) according to different treatment method. The patients in the control group treated with percutaneous nephrolithotorny, the patients in the treatment group were treated with flexible ureteroscopy and holmium laser lithotripsy on the bassis of the control group. Compared the operation time, hospital stays, intraoperative blood loss, effective rate and complication incidence rate between two groups. Measurement data were expressed as mean± standard deviation (Mean±SD), and t-test was used for comparison between groups; count data was compared by Chi-square test. Results In the control group, the operation time, length of hospital stay and intraoperative blood loss were (65.85±3.83) min and (8.83±4.00) d, (130.72±1.20) ml, respectively, the treatment group were (43.44±3.16) min, (5.72±1.07) d, (96.21±0.98) ml, respectively, the difference between group there was statistical significance (P<0.05); the total effective rate of the control group was 84.0% (58/69), which was significantly lower than that of the treatment group [95.7% (67/70)], and the difference between the groups was statistically significant (P<0.05). The incidence of postoperative complications of the treatment group[2.8% (2/70)] was significantly lower than the control group[14.5% (10/69)], and the difference between the two groups was statistically significant (P<0.05). Conclusion The complicated renal calculi by percutaneous nephrolithotomy combined with flexible ureteroscopy and holmium laser lithotripsy has the advantage of short operation time, less blood loss, faster recovery and low complication incidence rates, has clinical use and promotion value. Key words: Kidney calculi; Nephrostomy, percutaneous; Postoperative complications; Flexible ureteroscopy