Effects of Different Minimally Invasive Operation for Patients with Impacted Upper Ureteric Calculi

CHENG Hong-gang

doi:10.3969/j.issn.1004-5775.2014.06.014

Abstract：Objective To compare the clinical efficacy of three kinds of minimally invasive operation in the treatment of impacted upper ureteric calculi , and provide a theoretical basis for the clinical operation mode selection .Methods 141 patients with impacted upper ureteric calculi treated in the hospital were selected and randomly divided into A , B, C groups with 47 cases in each group .Patients in group A were treated with transurethral ureteroscopic lithotripsy ( URSL) .Patients in group B were treated with minimally invasive percuta-neous nephrolithotomy ( MPCNL) .Patients in group C were treated with retroperitoneal laparoscopic ureterolithotomy ( RLU) .The opera-tion time, hospitalization days , situation of extracorporeal shock wave lithotripsy ( ESWL ) treatment after operation , stone clearance rate and incidence of adverse reaction of the three groups were compared .Results The operation time of group A was (51.59 ±17.13) min, which was significantly shorter than group C (P<0.05).The hospitalization days of group A was (5.62 ±1.17)d, which was significantly longer than group C and significantly shorter than group B (P<0.05).36.17%cases in group A were given ESWL , which was significant-ly higher than that of group B and C (P<0.05).The stone clearance rate 3 days and 1 month after the operation of group A were 51.06%and 82.98%, which were significantly lower than group B and C (P<0.05).The incidences of adverse reaction of the three groups were 14.89%, 8.51%and 6.38%.The differences in the incidence of adverse reaction of the three groups were not statistically significant (P>0.05).Conclusion URSL can be used if the stone position is low and volume is small .If the stones near the calyx or complicated with severe hydronephrosis , MPCNL can be considered .RLU can be used when URSL and MPCNL treatment fails .