Effects of minimally invasive percutaneous nephrolithotomy combined with ureteroscopic holmium laser lithotripsy on intraoperative blood loss and postoperative stone clearance rate in patients with staghorn nephrolithiasis

Abstract

Objective To investigate the effect of minimally invasive percutaneous nephrolithotomy combined with ureteroscopic holmium laser lithotripsy on intraoperative blood loss and postoperative stone clearance in patients with staghorn nephrolithiasis. Methods Sixty-nine patients with staghorn nephrolithiasis in urgent care centre were randomly divided into control group (n=34) and observation group (n=35) according to different surgical procedures. The control group underwent conventional percutaneous nephrolithotomy with holmium laser lithotripsy, and the observation group was treated with minimally invasive percutaneous nephrolithotomy combined with ureteroscopic holmium laser lithotripsy. The surgery conditions (surgery time, intraoperative blood loss), stone clearance rate and postoperative conditions (intestinal function recovery, get out of bed, discharge time) were observed and compared between the two groups, and the incidences of complications and the quality of life (GQOLI) score were statistically analyzed. Results The intraoperative blood loss in the observation group was lower than that in the control group, the difference was significant (P<0.05). The removal rate of stone in the observation group [91.43% (32/35)]was higher than that of the control group [(64.71%, 22/34)], the difference was significant (P<0.05). The intestinal function recovery, get out of bed time and discharge time in the observation group was lower than that in the control group, the differences were significant (P<0.05). The incidence of complications in the observation group [5.71% (2/35)] was lower than that in the control group [(26.47%, 9/34)], the difference was significant (P<0.05). The postoperative GQOLI score in the observation group was higher than that in the control group, the difference was significant (P<0.05). Conclusions The minimally invasive percutaneous nephrolithotomy combined with ureteroscopic holmium laser lithotripsy in the treatment of staghorn nephrolithiasis has significant effect, which can reduce the intraoperative blood loss, promote postoperative recovery, improve stone clearance and quality of life, with higher safety. Key words: Antler-shaped kidney stones; Minimally invasive percutaneous nephrolithotomy; Ureteral softening holmium laser lithotripsy; Ntraoperative blood loss; Stone clearance rate