Comparative study of therapeutic effect of retrograde flexible ureteroscopic lithotripsy combined with single-tract versus double-tracts percutaneous nephrolithotomy in treatment of multiple kidney stones in elderly patients

Abstract

Objective To investigate the efficiency of retrograde flexible ureteroscopic lithotripsy(RFURL)combined with single-tract(S-PCNL)versus double-tracts(D-PCNL)percutaneous nephrolithotomy in the treatment of multiple kidney stones(>2cm)in elderly patients. Methods From January 2011 to July 2015, 69 elderly patients with multiple kidney stones were enrolled.32 cases were treated by RFURL combined with S-PCNL and the other 37 cases with D-PCNL.The surgery time, hemoglobin(Hb)level change at first postoperative day, visual analogue pain score(VAS), the stone clearance rate and the postoperative complications were compared between the two groups. Results Compared RFURL combined with D-PCNL group, S-PCNL group showed that the surgery time was longer [(90.4±32.6)min vs.(72.3±21.4)min, t=4.139, P<0.05], Hb level decrement was less [(11.2±6.3)g/L vs.(15.7±8.1)g/L, t=-4.625, P<0.05], VAS was less [(4.2±1.2)vs.(4.5±1.4)], hospital stay was shorter [(6.2±1.2)d vs.(7.1±1.5)d], the stone clearance rate was higher(93.8% vs.91.9%). Postoperative fever(more than 38.5℃)was found in 2 cases in S-PCNL group and 1 case in the D-PCNL group.2 patients in D-PCNL group needed blood transfusion after surgery. Conclusions RFURL combined with S-PCNL is safe and effective in treating multiple kidney stones(>2 cm)in elderly patients.Compared with D-PCNL, RFURL combined with S-PCNL therapy may reduce the risk of hemorrhage. Key words: Kidney calculi; Ureteroscopes; Nephrostomy, percutaneous