Comparison of sun's tip-flexible ureterorenoscopy and minimally invasive percutaneous nephrolithotomy in the treatment for senile upper ureteral incarcerated calculi

Abstract

Objective To compare the efficacy of Sun's tip-flexible ureterorenoscopy and minimally invasive percutaneous nephroscopy in the treatment of incarcerated upper ureteral calculi in elderly patients. Methods From July 2016 to December 2017, 60 elderly patients with upper ureteral incarcerated calculi were selected from the department of urology of the Huaian hospital affiliated to Xuzhou medical university. According to the order of hospitalization, it was divided into the Sun's tip-flexible ureterorenoscopy (30 cases) and the minimally invasive percutaneous nephroscope (30 cases), respectively, with Sun's tip-flexible ureterorenoscopy and minimally invasive percutaneous nephrolithotomy. The one-time success rate, stone clearance rate, intraoperative bleeding volume, postoperative hospital stay, postoperative complications, postoperative comfort, pain and trauma index (TNF-a, IL-6 and CRP) were compared between the two groups. Results The two groups were successful in the first stage operation, and there was no significant difference between the two groups after 1 month of operation (P>0.05). The intraoperative bleeding volume, postoperative hospitalization time and incidence of postoperative complications in the Sun's tip-flexible ureterorenoscopy group were significantly lower than those in the minimally invasive percutaneous nephrolithotomy group (P<0.05), and the pain scores in the Sun's tip-flexible ureterorenoscopy group were significantly lower than those in the minimally invasive percutaneous nephrolithotomy group (P<0.05), while the comfort scores were significantly higher than those in the minimally invasive percutaneous nephrolithotomy group (P<0.05). The levels of serum TNF-α, IL-6 and CRP in both groups increased 24 hours after operation, but decreased 72 hours later. The levels of TNF-α, IL-6 and CRP in percutaneous nephroscopy group were significantly higher than those in Sun's tip-flexible ureterorenoscopy group at different time points (P<0.05). Conclusions Sun's tip-flexible ureterorenoscopy and minimally invasive percutaneous nephroscope both have high lithotripsy efficiency in the treatment of incarcerated upper ureteral calculi in the elderly, but Sun's tip-flexible ureterorenoscopy has the advantages of small trauma, low complications and high comfort, which is worthy of wide clinical application. Key words: Ureteral Calculi; Ureteroscopy; Nephrostomy, Percutaneous