ABSTRACT
Objective:
To investigate the
clinical efficacy and
safety of transurethral flexible
ureteroscopy combined with single channel minimally invasive percutaneous nephroscopy in the
treatment of complex
renal calculi.
Methods:
A total of 72
patients with complex
renal calculi admitted to
Beijing Friendship Hospital,
Capital Medical
University from November 2019 to April 2022 were prospective selected, which were randomly divided into study group and
control group by the random number table
method, with 36 cases in each group. The
control group underwent single channel minimally invasive
percutaneous nephrolithotomy, while the study group underwent transurethral flexible
ureteroscopy combined with single channel minimally invasive
percutaneous nephrolithotomy. The perioperative indexes (operation
time, postoperative
hospital stay, intraoperative
blood loss), stone removal effect, renal function
indicators [
blood urea nitrogen (
BUN),
serum creatinine (SCr)] and complication rate were compared between the two groups. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for inter-group comparison. The
Chi-square test or Fisher exact
probability method were used to compare the count data of two groups.
Results:
The operation
time [(101.05±11.34) min vs (107.84±10.28) min] and postoperative
hospital stay [(8.54±3.15) d vs (12.36±4.08) d] in the study group were significantly shorter than those in the
control group, and the difference were statistically significant ( P<0.05). The amount of intraoperative
bleeding was close to that in the
control group, but the difference was not statistically significant ( P>0.05). The primary stone clearance rate and summary stone clearance rate in the study group were 91.67% (33/36) and 100.0% (36/36), respectively, which were significantly higher than 69.44% (25/36) and 83.33% (30/36) in the
control group, and the differences were statistically significant ( P<0.05). The postoperative
BUN and SCr levels in the study group were (5.24±0.31) mmol/L and (90.65±25.57) μmol/L, respectively, the
control group was (7.69±0.78) mmol/L and (131.96±37.80) μmol/L, respectively.
BUN and SCr levels in the study group were significantly lower than those in the
control group, and the differences were statistically significant ( P<0.05). The total
incidence of
postoperative complications in the study group was significantly lower than that in the
control group (5.56% vs 16.67%), and the difference was statistically significant ( P<0.05).
Conclusion:
Transurethral flexible
ureteroscopy combined with single channel minimally invasive percutaneous nephroscopy is an ideal
method for the
treatment of complex
renal calculi, which has good removal effect, less
complications and helps to improve renal function.