Clinical effect comparison of minimally invasive percutaneous nephrolitho tomy and ureteroscopy lithotripsy for upper ureteral calculi

Objective To explore the clinical effects and safety of minimally invasive percutaneous nephrolithotomy(MPCNL) and ureteroscopy lithotripsy(URL) for upper ureteral calculi.Methods 176 patients with upper ureteral calculi from May 2010 to May 2013 in the Urology Department of the People's Hospital of Shangyu City were selected as study objects,and were randomly divided into MPCNL group and URL group,with 88 patients in each group.The patients of MPCNL group were given MPCNL treatment and the patients of URL group were given URL treatment.The operation time,intraoperative blood loss,length of hospital stay,calculi clearance rate in 3 days and 1 month after operation and incidence of complications of two groups were compared.Results The operative time,intraoperative blood loss and length of hospital stay of URL group [(45.1±13.2) min,(68.7±25.2) mL,(5.9±1.7) d] were significantly less than those of MPCNL group [(79.2±22.4) min,(136.4±38.1) mL,(10.2±3.5) d],the differences were statistically significant(P 0.05).However,the calculi clearance rates of 3 days and 1 month after the operation of URL group(73.9%,89.8%) were lower than those of URL group(90.9%,100.0%),the difference was statistically significant(P 0.05);there were no significant differences of the incidence of complications between the two groups(all P 0.05).Conclusion URL can be used for simple upper ureteral calculi for the less injury and intraoperative blood loss,shorter operative time and length of hospital stay;while MPCNL can be the first choice for complicated upper ureteral calculi because of the advantage of high calculi clearance rate,safety and efficacy.