Comparison of efficacy and safety between super-mini-percutaneous nephrolithotomy and flexible reteroscope lithtripsy in the treatment of lower calyx calculus

Abstract

Objective To compare the safety and efficacy between flexible ureteroseope lithtripsy (FURS) and super-mini-percutaneous Nephrolithotomy (SMP) in the treatment of lower calyx calculus. Methods From Mar 2015 to Apr 2017, 120 male and 75 female patients were accepted FURS(n=112)or SMP(n=83) in our hospital.Their average age was 45 years old, ranged from 19 to 68 years old. The cumulative stone diameter ranged from 15-24 mm (mean 20.3±3.9 mm) in FURS group and ranged from 15-28 mm (mean 20.7±3.2mm) in SMP group.There were no significant differences between the groups FURS and SMP in the stone size(P>0.05). Operative duration, postoperative hospital stay, complication rate, and stone-free rate(one day or one month after procedure) were recorded and compared. Results The operative time ranged from 28 to 62 min (mean 55.3±7.3min) in FURS group and ranged from 15 to 55 min (mean 40.5±6.8 min) in SMP group (P<0.05). One day after the operation, CRP was 7.4-29.1 (mean 17.2±7.1) mg/L in group SMP, which was lower than that in group FURS 6.9-37.8 (mean 26.4±6.4) mg/L (P<0.05). And the procalcitonin and peripheral leukocyte count was 0.1-1.2 (mean 0.6±0.3)ng/ml and 6.3-18.1(mean 12.6±3.2)×109/L respectively, which was lower than that in group FURS 0.2-1.4 (mean 0.9±0.4)ng/ml and 9.5-21.7(mean 14.8±2.9)×109/L respectively (P<0.05). One day after the operation, the stone free rate was 80.4%(90/112) in group FURS, which was lower than that in group SMP 89.2%(74/83) (P<0.05). And one month after the operation, the stone free rate was 85.7%(96/112) in group FURS, which was lower than that in group SMP 96.4% (80/83) (P<0.05). Postoperative hospitalization stay ranged from 2 to 5 days(mean 2.3±1.2 days) and ranged from 3 to 6 days (3.7±1.6 days) in FURS and SMP group, respectively (P<0.05). The scores of Visual Analogue Scale (VAS) ranged from 0 to 3 (mean 2.1±0.4) and ranged from 0 to 3 (mean 1.9±0.5) in FURS and SMP group, respectively (P<0.05). And the scores of Bruggrmann comfort scale (BCS) ranged from 2 to 4 (mean 3.2±0.7) and ranged from 2 to 4 (2.8±0.5) in FURS and SMP group, respectively(P<0.05). Conclusions Both SMP and FURS are efficacy and safe surgical alteration for patients with renal and renal lower calyx calculus of CSD about 2cm.The SMP could have some advantages such as the better stone free rate and acceptable complication rate. Key words: Renal and ureteral calculus; Flexible ureteroseope; Super-mini-percutaneous Nephrolithotomy; Safety; Effectivity