Influence on systemic stress response and peripheral blood T lymphocyte subsets after simultaneous flexible ureteroscopic lithotripsy of bilateral upper urinary tract stones

Abstract

Objective To evaluate the feasibility and safety of simultaneous flexible ureteroscopic in the treatment of bilateral upper urinary tract stones from systemic stress response and immune function changes. Methods Sixty bilateral upper urinary tract stones patients who had underwent flexible ureteroscopic lithotripsy (FURL) from December 2015 to December 2017 were selected. The patients were divided into simultaneous FURL treated bilateral upper urinary tract stones (group A, 29 cases) and FURL treated unilateral upper urinary tract stones (group B, 31 cases) according to the treatment method. The perioperative period indexes were recorded. The serum epinephrine (E), norepinephrine (NE), cortisol and peripheral blood T lymphocyte subsets 1 d before operation and 1, 3, 5 d after operation were detected. Results There were no statistical differences in length of stay in hospital, incidence of postoperative complications and stone clearance rate between 2 group (P>0.05). The operating time in group A was significantly longer than that in group B: (108.3 ± 11.5) min vs.(86.9 ± 13.3) min, and there was statistical difference (P 0.05). The E, NE and cortisol levels only 1 d after operation in 2 groups were significantly higher than those before operation, and there were statistical differences (P 0.05). Compared with those before operation, the peripheral blood CD3+, CD4+ and CD4+/CD8+ levels 1 and 3 d after operation in 2 groups were significantly lower, the CD8+ was significantly higher, and there were statistical differences (P 0.05). Conclusions It is feasible, safe and effective to perform simultaneously flexible ureteroscopic for bilateral upper urinary tract calculi patients. And this treatment will not increase the risks of transient adrenal dysfunction and immunosuppression Key words: Urinary calculi; Ureteroscopes; T-lymphocyte subsets; Systemic stress response