Clinical observation on multiplex-endoscopy combination therapy for acute and complicated urinary tract calculous obstruction

YUAN Chaoying; HUANG Suxi; YUAN Jie; YAN Dong; HAI Lati·Abudulijiang; ZHOU Haihui; XIAO Huaping

doi:10.13919/j.issn.2095-6274.2016.03.009

Abstract：Objective To observe the efficacy of multiplex-endoscopy combination therapy for acute and complicated urinary tract calculous obstruction.Methods Clinical data of 236 patients with acute and complicated urinary tract calculous obstruction treated with ureteroscopy, flexible ureteroscope and percutaneous nephrolithotomy were analyzed retrospectively. 176 patients were treated with two or more than two endoscopy (multiplex-endoscopy group), and 60 patients with a single endoscopy (single endoscopy group). Then operation time, hospitalization length, stone free rate, degree of inflammatory reaction, and surgical complications were compared between the two groups.Results All obstructions of 236 patients were successfully removed; none of them changed to open surgery; no ureteral avulsion fracture, kidney hemorrhage and other serious complication happened. Compared with single endoscopy group, hospitalization length was shorter (t=1.371,P=0.046), stone free rate was higher (t=0.426,P=0.035), number of patients who need percutaneous nephrolithotomy twice or more was larger (χ2=41.183,P<0.001), postoperative neutrophils ratio (χ2=2.375,P=0.029) and c-reactive protein values (χ2=107.102,P<0.001) were reduced in multiplex-endoscopy group, and differences were statistically significant. Difference between two groups in operation time, blood transfusion and fever had no statistical significance.Conclusions Multiplex-endoscopy combination therapy for acute and complicated urinary tract calculous obstruction show advantages in stone free rate, hospitalization length, and first phase of relieve obstruction rate, also it is safe, minimally invasive and worthy of clinical popularization and application.