The effect of super mini percutaneous nephrolithotomy combined with flexible ureteroscopic lithotripsy in the treatment of complex renal calculus and its effects on renal hemodynamics and stress response
Hou Junkun
Chen Yao
Guan Jiawei
Chang Youzhong
Liu Pan
Abstract：Objective:To investigate the effect of super mini percutaneous nephrolithotomy(SMP)combined with flexible ureteroscopic lithotripsy(FURL)in the treatment of complex renal calculus and its effects on renal he-modynamics and stress response.Methods:A total of 225 patients with complicated renal calculus in our hospital from January 2019 to August 2021 were selected and divided into three groups according to the random number table method,with 75 cases in each group.GroupAwas treated with SMP combined with FURL,group B was treated with SMP,and group C was treated with FURL.The rate of stone removal,operation,postoperative,renal hemo-dynamic indicators[end-diastolic flow velocity(Vmin)of renal segmental artery,peak systolic flow velocity(Vmax),resistance index(RI)],stress reaction indicators[serum cortisol(Cor),norepinephrine(NE),adreno-corticotropic hormone(ACTH)]before and after operation,quality of sexual life and rate of complications were com-pared between the three groups.Results:Thestone removal rate of group A was higher than that of group B and C,and the stone residual rate was lower than that of group B and C(P＜0.05).There were no significant defferences in the stone removal and residual rate between that of group B and C(P＞0.05).Compared with group C,Groups A and B had higher intra-operative hemorrhagic volume,postoperative first off-bed time,and hospital staywith statistical significance(P<0.05).Compared with preoperative,the three groups had lower Vmin and Vmax postoperative 1d,group A and B was lower than that of group C,higher RI,serum Cor,NE,and ACTH postoperative1d,sexual life scoreof patient and spousepostoperative three months,group A and B were higher than that of group C with statistical significance(P<0.05).There was no significant differences in the rate of complications between the three groups(P>0.05).Conclusion:The combination of SMP and FURL for complex renal calculus significantly improves stone removal rate,reduces stone residual rate,and improves postoperative quality ofsexual life more significantly,and does not increase the impact on renal hemodynamics,stress response,or risk of complications compared with SMP.
Keywords：kidney calculinephrolithotomypercutaneousureteroscopeshemodynamicsstress response
Publication Date：2023-10-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 298-304 )