Comparison of flexible ureteroscopy and extracorporeal shock wave lithotripsy for residual calculi after single-tract percutaneous nephrolithotomy

Abstract

Objective To investigate the clinical effect between flexible ureteroscopy (fURS) and extrocorporeal shock ware lithotripsy (ESWL) in the treatment of residual stones after the management of complex calculi with single-tract percutaneous nephrolithotomy. Methods 105 patients with complex calculi in our hospital from Jan 2014 to Dec 2016 were selected as study subjects. Among them, 60 patients accepted fURS after single channel PCNL (test group, n=60), and 45 patients accepted ESWL after single channel PCNL (control group, n=45). General data, perioperative parameters and complications of the two groups were analyzed and compared. Results The experimental group were significantly better than the control group in terms of average operation time, operation success rate, stone clearance rate, and the need for re-treatment rate (t or χ2 were 6.255, 7.415, 9.358, 10.423, respectively; P values were 0.000, 0.006, 0.002, and 0.001, respectively). The cases of complications in postoperative pain and renal dysfunction in the experimental group was less than that in the control group, and the overall complication rate in the experimental group was significantly lower than that in the control group (χ2=6.369, P=0.012). Conclusion As for patients with residual calculus after single-channel PCNL, compared with ESWL, the stone clearance rate of fURS treatment is higher, and the postoperative complications are lower, with higher safety, which is worthy of clinical promotion. Key words: Flexible ureteroscopy; Holmium laser; ESWL; Complex calculi; Residual stones