Comparison of percutaneous nephrolithotomy and flexible ureteroscope for the management of 2 ～ 4 cm renal stones
摘要
Objectives TO compare the outcomes of percutaneous nephrolithotomy (PCNL) and flexible ureteroscope in the treatment of 2 ～ 4 cm kidney stones.Methods And methods between September 2009 and January 2011,34 patients who had renal stones ranging from 2 to 4 cm in diameter were treated with flexible ureteroscope and 36 patients who had renal stones ranging from 2 to 4 cm in diameter were treated with percutaneous nephrolithotomy.We compare the stone-free rate,operation time,hospital stay and complication after operation.Results Stone-free rates after one session were 73.5％ and 88.9％ for flexible ureteroscope and PCNL respectively(P＜0.05).Stone-free rate in the flexible ureteroscope group improved to 88.2％ after the second procedure.With the following up after three months,clearance rates were up to 94.1％ or 94.4％ respectively(P ＞ 0.05).Meanoperation duration was 58.2 ± 13.4 min in the flexible ureteroscope group but 38.7 ± 11.6 min in the PCNL group(P ＜0.0001).Overall complication rates in the PCNL group were higher,but the differences were not statistically significant.Hospitalization time was significantly shorter in the flexible ureteroscope group (30.0 ± 37.4 vs 61.4 ± 34.0 h,respectively; P ＜ 0.001).Conclusions Satisfactory outcomes can be achieved with multi-session flexible ureteroscope in the treatment of 2 ～4 cm renal stones.Flexible ureteroscope can be used as an alternative treatment to PCNL in selected cases with larger renal stones. Key words: Kidney Calculi ; Ureteroscopy