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Comparison of flexible ureteroscopy and percutaneous nephrolithotomy for the management of 10–20‐mm renal stones: A 5‐year retrospective study
Author(s) -
Liao Wenbiao,
Yang Sixing,
Qian Huijun,
Song Chao,
Xiong Yunhe
Publication year - 2014
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12076
Subject(s) - medicine , percutaneous nephrolithotomy , blood transfusion , surgery , retrospective cohort study , percutaneous , incidence (geometry) , body mass index , physics , optics
Aim The aim of the present study was to review our 5‐year experience and compare the outcomes of flexible ureteroscopy ( fURS ) and percutaneous nephrolithotomy ( PCNL ) for treating 10–20‐mm renal stones. Patients and Methods In this retrospective study, we compared 310 patients with renal stones of 10–20‐mm size treated with PCNL ( n = 164) or fURS ( n = 175) between M arch 2008 and M arch 2013. The parameters of patients included age, body mass index and sex, as well as the size, location, and previous stone treatments. Factors, such as operation duration, hospitalization time, drop in haemoglobin level, complications, stone‐free rate ( SFR ) and necessitating blood transfusion were analysed. Results The two groups had comparable demographic data, such as age, sex, stone size and localization. The mean operation duration for PCNL was 52.6 min, and for fURS , 81.3 min ( P < 0.001). The mean hospitalization time for PCNL was 7.5 days, and for fURS , 4.3 days ( P < 0.001). The mean drop in haemoglobin level and necessitating blood transfusion for fURS was less than that for PCNL ( P < 0.001). Postoperative complications, such as fever and urine leakage after PCNL , were significantly higher than that after fURS , but the incidence of sepsis in both groups had no difference ( P > 0.05). The SFR was 82.3 per cent after fURS and 91.4 per cent after PCNL at the first day, postoperatively ( P > 0.05). Four weeks after the staged procedure, the SFR was 96.4 per cent after fURS and 97.7 per cent after PCNL ( P > 0.05). After the second‐stage procedure, the SFR was significantly higher than that at the first day, postoperatively, in the fURS group (82.3 per cent vs 96.4 per cent, P < 0.05). Conclusion Both PCNL and fURS are effective for renal stones that are 10–20 mm in size. Although accompanied by higher rate of second‐stage procedures and longer operation duration, compared with PCNL , fURS has the advantages of reduced hospital stay, reduced blood transfusion requirements and decreased postoperative complications. fURS is a good alternative for renal stones that are 10–20 mm in size.