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The comparative analysis of three different mini-invasive methods for upper ureteric calculi which is bigger than 12 mm

Objective: To compare the differences of clinical effect and complications of Percutaneous Nephrostolithotomy (PCNL), Ureteroscopic Pneumatic Lithotripsy (UPL) and Ureteroscopic Holmium Laser Lithotripsy (UHLL) in the treatment of upper ureteric calculi which is bigger than 12 mm.

Methods: Totally 196 patients with upper ureteric calculi which is bigger than 12 mm in our hospital were selected as research object from May 1, 2012 to April 30, 2012, and divided into PCNL group (66 cases), UPC group (65 cases) and UHLL group (65 cases) according to the operation method. The condition of operation, postoperative complications, stone expulsion rate and recurrence rate between the three groups were compared.

Results: The operation time of PCNL group was significantly less than that in UPL group and UHLL group (40.9 ± 12.5 vs. 55.1 ± 13.2 vs. 50.7 ± 10.1, P<0.05); the hospital stays were significantly longer than that in UPL group and UHLL group (4.7 ± 1.3 vs. 3.2 ± 0.6 vs. 2.8 ± 0.4, P<0.05); the decline of intraoperative hemoglobin was significantly larger than that in UPL group and UHLL group (2.9 ± 0.7 vs. 1.3 ± 0.5 vs. 1.2 ± 0.7, P<0.05); the successful lithotriptic rates of PCNL group, UPL group and UHLL group were 100.00% (66/66), 89.23% (58/65), 92.31% (60/65) respectively. The stone expulsion rate of PCNL group was significantly higher than that of UPL group and UHLL group (P<0.05). There was no significant difference in total incidence of complications between three groups (P>0.05).

Conclusion: Three methods for upper ureteric calculi which is bigger than 12 mm are well effective. Comparing with UPL and UHLL, PCNL has the advantage of short operation time and hospital stays, as well as better effect on lithotripsy and expulsion, which is recommended adopting in clinical.

Author(s): Wei-wei Zhang, Peng Sun, Qian Yu, Hai-xiao Wu