Efficacy Comparison of Flexible Ureteroscopy and Mini-percutaneous Nephrolithotomy for Multiple Renal Calculi

Liu Chengmeng; Tang Xiangyu; Wang Yun; Qu Genyi; Li Jupeng

doi:10.19558/j.cnki.10-1020/r.2025.06.001

Abstract：Objective To compare the therapeutic efficacy of flexible ureteroscopy(f-URS)and mini-percutaneous nephrolithotomy(mPCNL)in the treatment of multiple renal calculi sized 1-2 cm.Methods The clinical data of patients with 1-2 cm multiple renal calculi who underwent f-URS or mPCNL at Zhuzhou Hospital Affiliated to Xiangya School of Medicine,Central South University from January 2022 to June 2024 were retrospectively analyzed.Propensity score match-ing(PSM)was applied for cohort matching,and a total of 120 patients were enrolled.All patients were divided into two sub-groups according to the number of calculi(≤3 vs.>3 calculi).The safety and effectiveness of the two surgical approaches were compared.Results The f-URS group showed significant advantages over the mPCNL group in terms of postoperative hospital stay[(3.05±1.52)d vs.(7.63±1.48)d,t=15.060,P<0.001],operative time[(84.91±38.92)min vs.(100.58±29.29)min,t=2.370,P=0.027],and complication rate[8.8%vs.30.0%,χ2=7.530,P=0.006].There was no statistically signifi-cant difference in stone-free rate between the two groups(P>0.05).In the subgroup with≤3 calculi,the f-URS group had shorter operative time[(77.59±40.73)min vs.(100.04±28.56)min,t=2.500,P=0.015]and lower complication rate[6.5%vs.23.1%,χ2=4.180,P=0.041]compared with the mPCNL group.However,no statistically significant differences were ob-served between the two surgical approaches in the subgroup with>3 calculi(P>0.05).Conclusion For multiple renal stones measuring 1-2 cm,f-URS can achieve stone-free rates comparable to those of mPCNL when the number of stones is≤3,while offering shorter postoperative recovery,reduced operative time,and a lower risk of complications.When the number of stones exceeds 3,the clinical efficacy of the two surgical approaches appears to be comparable.