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Single Percutaneous Tract Combined with Flexible Nephroscopy in the Management of Kidney Stones 2-4 cm: Better Options of Treatment Protocols

Xiaobo Zhang, Jie Gu, Xiong Chen, Yuanqing Dai, Mingquan Chen, Sheng Hu, Zhenyu Liu, Dongjie Li
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Abstract

Purpose: To investigate the safety and efficacy of Single Percutaneous Tract Combined with Flexible Nephroscopy in the Management of 2-4 cm renal calculi.

Materials and Methods: We retrospectively analysed the treatment data of patients with 2-4 cm renal calculi from June 2010 to June 2017. The data included 217 cases of percutaneous nephrolithotomy (PNL), 441 cases of retrograde intrarenal surgery (RIRS) and 217 cases of single-access percutaneous nephrolithotomy combined with flexible nephroscopy (PNCFN). The collected data were analyzed..

Results:

A total of 875 cases were studied, with an average age of 42.35 ± 10.29 years. Group PNCFN showed the highest stone-free rates (SFRs)(73.7 vs 66.7 vs 80.2, P=.00), best patient satisfaction (89.84 vs 87.23 vs 92.29, P=.00). The length of stay was shorter in group RIRS than other two groups (5.22 vs 5.65 vs 3.72, P=.00). Haemoglobin decrease (> 10 g/L) was higher in group PNL than that in group RIRS and group PNCFN (P=.012). Hospitalization fees (RMB) were Increased in group PNCFN compared with that in group PNL and group RIRS (34563.45 vs 21334.69 vs 33343.16, P=.000). Treatment protocols of PNL decreased from 17.51% to 9.22%, those for RIRS from 5.22% to 17.69%, peaking at 2012, PNCFN from 8.29% to 15.67% showed a rapid growth trend.

Conclusion: The percutaneous nephrolithotomy combined with flexible nephroscopy treatment on renal calculi of 2-4 cm was associated with higher stone-free rates and better patient satisfaction than RIRS and PNL. Comprehensive consideration and conservative use for RIRS treatment of 2-4 cm renal stones.


Keywords

flexible nephroscopy; percutaneous nephrolithotomy; retrograde intrarenal surgery; patient satisfaction



DOI: http://dx.doi.org/10.22037/uj.v0i0.5427

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