Retrospective study of visualized ultra-mini percutaneous nephrolithotripsy vs. flexible ureterorenoscopy for nephrolithiasis patients with 1.5-2.5 cm kidney stones and without hydronephrosis.

Abstract

To investigate the safety and efficacy of visualized ultra-mini percutaneous nephrolithotripsy (VUMP) and flexible ureterorenoscopy (FURS) in the treatment of nephrolithiasis patients with 1.5-2.5 cm kidney stones and without hydronephrosis. The clinical data of 143 nephrolithiasis patients without hydronephrosis (from April 2017 to March 2021) were collected and analyzed, including 65 cases in the VUMP group and 78 cases in the FURS group. The general clinical data, operation time, hospitalization time, recent stone-free rate (RSFR), long-term stone free rate (four weeks after operation, LSFR), Visual Analogue Scale (VAS), Bruggermann comfort score (BCS), and surgical complications of the two groups were collected and analyzed. In the VUMP group, the operation time (49.14 ± 9.28 vs. 60.23 ± 9.45, p < 0.001), postoperative white blood cell count (11.05 ± 2.43 vs. 13.57 ± 2.71, p < 0.05) and BCS score (1.72 ± 0.80 vs. 2.81 ± 0.85, p < 0.001) were significantly lower than those of the FURS group, but the postoperative hemoglobin (8.25 ± 5.04 vs. 4.05 ± 3.07, p < 0.05), hospital stay (5.72 ± 1.75 vs. 3.12 ± 1.09, p < 0.001) and VAS score (3.18 ± 1.36 vs. 2.08 ± 1.28, p < 0.001) were significantly higher than those of the FURS group. Besides, the VUMP group was significantly higher than the FURS group in RSFR (90.32% vs. 72.22%, p < 0.05) and LSFR (95.38% vs. 85.89%, p < 0.05). The systemic inflammatory response syndrome rate (3.07% vs. 14.10%, p = 0.037) and total complications (9.23% vs. 20.51%, p = 0.032) were significantly lower in the VUMP group than in the FURS group. Both VUMP and FURS are safe and effective in the treatment of nephrolithiasis patients with 1.5-2.5 cm kidney stones and without hydronephrosis, and the former is preferable for higher SFR, shorter operation time and lower complication rate.