A comparative study of rigid combined flexible ureteroscope homium laser lithotripsy with rigid ureteral access sheath and mini-percutaneous nephrolithotomy for pelvic calculi

ZhouJunhong; TangYanquan; LiaoZhijian; YinWeiqiang; HaoYuqian; LuYuntian

doi:10.3969/j.issn.2095-5146.2014.05.013

Abstract：Objective:To compare the clinical efficacy and safety of rigid combined flexible ureteroscope homium laser lithotripsy with rigid ureteral access sheath and mini-percutaneous nephrolithotomy for pelvic calculi.Methods:Between March 2012 and December 2013,of the total 132 cases,seventy-three cases underwent rigid combined flexi-ble ureteroscope homium laser lithotripsy with rigid ureteral access sheath (group A),and 5 9 cases underwent mini-percutaneous nephrolithotomy (group B).The operating time,hemoglobin decreased value,postoperation hospital stay time,stone residue rate and complication were compared between the two groups.Results:There was no signifi-cant difference between the two groups in terms of age,gender,course of disease,position,degree of hydronephro-sis and stone size (P>0.05).66 cases of the total 73 cases in group A were completed successfully in the first proce-dure.The mean operating time was (40.3±8.3)min.The decreased mean hemoglobin value was (1.3±5.7)g/L. The mean post-operative hospital stay was (2.2±0.7)days.The stone residue rate was 9.1%.2 cases had fever af-ter operation.One case was suffered with renal colic.No case was suffered with ureteral transaction,avulsion,the renal pelvis tearing or other serious complications.No case was suffered with ureteral reflux after three months fol-lowing-up.All of the 59 cases in group B were completed successfully.The mean operating time was (74.6±12.2) min.The decreased mean hemoglobin value was (20.4±10.4)g/L.The mean post-operative hospital stay was (5.1 ±0.7)days.The stone residue rate was 5.1%.Except 2 cases were suffered with massive hemorrhage,no case was suffered with another serious complications.The operating time,the decreased hemoglobin value and the post-opera-tive hospital stay time had significant difference between the two groups (P<0.05).The stone residue rate and com-plication rate were not significantly different between the two groups (P>0.05).Conclusions:Of the two surgical technique,the rigid combined flexible ureteroscope homium laser lithotripsy with rigid ureteral access sheath has more advantages for the shorter operating time,less trauma,faster recovery,and lower severity of complications for pelvic calculi.