Super-mini percutaneous nephrolithotomy versus flexible ureteroscopy lithotripsy with holmium laser: an efficacy analysis in patients with symptomatic lower calyx renal calculi 1-2 cm

Abstract

Objective To compare super-mini percutaneous nephrolithotomy (SMP) and flexible ureteroscopy lithotripsy (FURL) for the treatment of the patients with symptomatic lower calyx calculi 1-2 cm. Methods From May 2016 to March 2018, 203 patients with symptomatic lower calyx calculi 1-2 cm who underwent SMP or FURL in our center were retrospectively analyzed. The patients were divided into two groups based on the surgical procedures: 96 cases in SMP group and 107 in FURL group. The postoperative outcomes were compared between two groups. Results Preoperative placement history of Double-J stents in SMP group was significantly lower than that in FURL group(P=0.012). However in stone essence, SMP group was obviously higher than FURL group(P=0.013). In terms of postoperative outcomes, less drop in hemoglobin level was significantly observed in FURL group(P=0.018). The stone-free rate (SFR) at the first day (83.3% vs. 68.2, P=0.013) and at the 4th week end (92.7 vs. 82.2, P=0.026) in SMP group were both statistically higher than in FURL group. Conclusions SMP is technically feasible and safe with lower incidence of bleeding and complications for the treatment of patients with lower calyx calculi 1-2 cm, and it can be used as a complementary operation method for FURL. Key words: Kidney Calculi; Lasers, Solid-State; Lithotripsy; Nephrostomy, Percutaneous; Ureteroscopy