A co mparison of t wo surgical procedures for co mplicated upper ureteral calculi

Zhou Liquan; Li Chengyang; Yang Zhanbin; Wang Xiao ming; Wang Xiang; Huang Hai peng; Guan Xiaofeng; Deng Yaoliang

doi:10.3969/j.issn.2095-5146.2015.02.008

Abstract：Objective :To co mpare the efficiency and safety of t wo procedures ,ureteroscopic lithotri psy (URL ) co mbi ned with ES WL and mi ni mall y i nvasi ve percutaneous nephrolithoto my (MPCNL ),for the treat ment of co mpli-cated upper ureteral calculi ,and i nvesti gate the selecti on of medical manage ment for co mplicated upper ureter calculi . Methods :21 0 cases of co mplicated upper ureter calculi were treated with URL co mbi ned with ES WL fro m January 2007 to August 2009 ,and 1 32 cases with MPCNL fro m Septe mber 2009 to April 201 1 .No patients experienced seri-ous co mplicati ons foll o wi ng URL co mbi ned with ES WL .Results :In the URL co mbi ned with ES WL cases ,the stone frag mentati on rate on one sessi on was 90.95 % (1 91 /21 0 ),and the stone free rate was 80.95 % (1 70/21 0 )and 88.09 % (1 85/21 0 )one week and one month after operati on respecti vel y .In the MPCNL cases ,the stone frag menta-ti on rate on one sessi on was 98 .48 % (1 30/1 32 )(P <0.05 ),and the stone free rate was 98.48 % (1 30/1 32 )(P <0.05 )one week and one month after operati on .One patient experienced severe renal access tract he morrhage after percutaneous nephrolithoto my .Conclusions :The therapeutic effect of URL co mbi ned with ES WL for co mplicated upper ureteral calculi is satisfactory .The therapeutic effect of MPCNL for the treat ment of co mplicated upper ureter-al calculi has co mparati ve advantage but there is hi gher risk of co mplicati on .For the co mplicated upper ureteral cal-culi the medical manage ment shoul d be defi nited accordi ng to medical technol ogy and facilities ,patient's expectati on and risk of co mplicati ons .