Clinical observation of minimally invasive percutaneous nephrolithotomy in the treatment of impacted upper ureteral stones

Objective To explore the effect of the minimally invasive percutaneous nephrolithotomy(MPCNL) in the treatment of impacted upper ureteral stones.Methods 115 cases of of impacted upper ureteral stones were studied retrospectively.According to the selection of operation,65 cases were underwent minimally invasive percutaneous nephrolithotomy lithotomy(MPCNL group) and 50 cases were underwent ureteroscopic lithotripsy(URL group).The stone-free rate,operative time,hospital stay,incidence of intraoperative complications,postoperative adjuvant therapy,postoperative complications and other data were analyzed.Results The stone-free rate at 3 days follow-up was 100.00% in MPCNL group,62.00% in URL group,the difference was statistically significant(P = 0).The stone-free rate at one month follow-up was 100.00% in MPCNL group and 84.00% in URL group(P = 0.001).In MPCNL group the operative time(t = 5.753,P = 0) and hospital stay(t = 8.635,P = 0) were significantly shorter than those in URL group.There were no significant differences in the rates of intraoperative complications,postoperative infection and hemoglobin decline between the two groups(P 0.05).In MPCNL group,the rates of adjuvant ESWL was 1.54%,significantly lower than 18.00% in URL group(P = 0.002).Conclusion MPCNL for impacted upper ureteral calculi has a good stone-free rate,few complications,safe and effective,which can be the first choice.