Comparative study of mini-percutaneous nephrolithotomy and flexible ureteroscopic lithotripsy for the management of diameter 10 to 20 mm renal stone in obese patients / 中国医师进修杂志

ABSTRACT

Objective To evaluate and compare the effectivity and safety of mini-percutaneous nephrolithotomy (mPNL) and flexible ureteroscopic lithotripsy (FURL) for diameter 10 to 20 mm renal stone in obese patients. Methods This was a multicenter prospective study. One hundred and ten obese patients (body mass index≥28.0 kg/m2) with diameter 10 to 20 mm kidney stone from January 2015 to May 2017 were selected. The patients were divided into mPNL group (58 cases) and FURL group (52 cases) according to the patients′ will. The operation time, hospitalization time, complication, one-stage stone removal rate and ultimate stone removal rate were compared between 2 groups. Results The operation time, hospitalization time and incidence of complication in FURL group were significantly lower than those in mPNL group (66.7 ± 21.9) min vs. (85.7 ± 33.4) min, (72.5 ± 23.7) h vs. (120.8 ± 33.5) h and 9.6% (5/52) vs. 31.0% (18/58), and there were statistical differences (P＜0.05). There were no statistical differences in the one-stage stone removal rate and ultimate stone removal rate between 2 groups (P＞0.05). In aspect of postoperative bleeding, hemoglobin decreased after operation (15.8 ± 9.7) g/L in mPNL group; no hemorrhage occurred in FURL group, and no significant changes in hemoglobin were observed before and after operation. Conclusions Both mPNL and FURL achieve satisfactory stone-free rates in obese patients with diameter 10 to 20 mm renal stone. Compared with mPNL, FURL has shorter operation time and lower incidence of complication.