Comparison of the effects of single-channel percutaneous nephrolithotomy combined with flexible ureteroscope and flexible ureteroscopic holmium laser lithotripsy in the treatment of complex kidney stones

Objective To compare the effects of single-channel percutaneous nephrolithotomy (PCNL) combined with flexible ureteroscope with flexible ureteroscopic holmium laser lithotripsy in the treatment of complex kidney stones.

Methods A total of 101 patients with complicated kidney stones were selected as study objects, and were divided into two groups according to different treatment plans. The control group (n=49) received flexible ureteroscopic holmium laser lithotripsy, and the observation group (n=52) received single-channel PCNL combined with flexible ureteroscope treatment. The operation conditions, renal function neutrophil gelatinase-associated apolipoprotein (NGAL), cystatin C (Cys-C), and blood creatinine (Scr), stress indicators adrenocorticotropic hormone (ACTH), norepinephrine (NE), and cortisol (Cor), complications and stone clearance rate were compared.

Results The recovery time of gastrointestinal function and hospital stay in the observation group was (3.84±1.02)d, (7.14±1.56) d, which were shorter than(4.42±1.39) d, (9.42±1.79)d of the control group (P < 0.05); the operation time in the observation group was (72.15±5.56) min, which was longer than (69.08±6.01) min in the control group (P < 0.05). The NGAL, Cys-C, Scr, ACTH, NE, and Cor in the two groups after operation were higher than those before operation, and NGAL, Cys-C, Scr, ACTH, NE, and Cor in the observation group were lower than those in the control group (P < 0.05). The total incidence of complications in control group and observation group were 10.20% and 3.85%, respectively, but no significant difference was found (P>0.05). The stone clearance rate in the observation group was 100.00%, which was higher than 87.76% in the control group, and the difference was statistically significant (P < 0.05).

Conclusion Compared with flexible ureteroscopic holmium laser lithotripsy, single-channel PCNL combined with flexible ureteroscope for patients with complex kidney stones has higher stone clearance rate, shorter postoperative gastrointestinal function recovery time, less damage to kidney function, and small stress response, and can make the patients discharge as soon as possible, but it has longer operation time.