Percutaneous nephrolithotomy (PCNL) versus flexible ureteropyeloscopy lithotripsy(f-URSL): a matched analysis of treatment in patients with single renal stones ≤ 4 cm comparing clinical efficacy and safety profile.
Shao-Wei Dong、Wei-Tung Kao、Chen-Hsun Ho、Chia-Chang Wu、Kuan-Chou Chen
Taipei Medical University-Shuang Ho Hospital Urology Dept.
 
Purpose: The objectives of the study are to compare the safety and efficacy of "all-seeing needle" optical puncture system percutaneous nephrolithotomy (PCNL) and flexible ureterorenoscopy lithotomy (F-URSL) for the treatment of single renal stones in UPJ or lower calyx of ≤ 4 cm and to determine the advantages and disadvantages of each.
Materials and Methods: Using previously recorded databases comparing PCNL and f-URS for the treatment of renal calculi. The primary outcome measurements were stone-free rates (SFRs) and complication rates for both techniques. Secondary outcome measurements were to compare patient demographics, operative duration, and inpatient stay, blood loss, remove double J timing.
Results: Among 223 patients (n = 134 for PCNL and n = 89 for FURS) and 60 patients (n = 30 for PCNL and n = 30 for f-URS) met inclusion criteria (single renal stone, no combined surgery, stone ≤ 4 cm). Demographics including age (p = 0.26), body mass index (BMI) (p = 0.51), and gender ratio (p = 0.6), were similar in both groups. Overall, SFR (stone free rate) was significantly greater in the PCNL group compared to the f-URS group [OR 2.01; 95% CI 1.53-2.64; p < 0.01]). Duration of inpatient stay was significantly greater in the PCNL group compared to the f-URS group (n = 6 ± 1.6 days versus n = 3 ± 1.2 days, respectively [p < 0.01]. Overall complication rates were not significantly different between PCNL and f-URS.
We found no significant differences in operating times, blood loss, days to remove double J and complication rates.
 
Conclusions: PCNL and f-URS are both safe and effective in the treatment of single medium-size urinary stones. But PCNL procedure needs more hospital stays and increased complication rate.
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    TUA秘書處
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    台灣泌尿科醫學會
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    2019-01-03 14:30:04
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    2019-01-03 14:58:43
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