Effect of ultra-mini percutaneous nephrolithotomy on prognosis of renal calculus patients complicated with diabetes mellitus

Objective To explore the effect of ultra-mini percutaneous nephrolithotomy (UMP) on the prognosis of renal calculus patients complicated with diabetes mellitus.

Methods The clinical materials of 107 renal calculus patients complicated with diabetes mellitus were retrospectively analyzed, and they were divided into percutaneous nephrolithotomy group (PCNL group) with 52 cases and UMP group with 55 cases according to different surgical methods. The perioperative indicators, stone clearance rate, renal function indexesblood urea nitrogen (BUN), serum creatinine (Scr), neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC), inflammatory factorsC reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), stress indicatorscortisol (Cor), norepinephrine (NE) and adrenocorticotropic hormone(ACTH), the incidence of complications and recurrence rate at 6 months after operation were compared between two groups.

Results Operation time, primary time to bed-off activity after operation, hospital stay and intraoperative blood loss in the UMP group were significantly shorter and lower than those in the PCNL group (P < 0.05). The stone clearance rates at one week and one month after surgery in the UMP group were 72.73% and 94.54% respectively, which were significantly higher than 57.69% and 80.77% in the PCNL group (P < 0.05). After treatment, the levels of BUN, Scr, NGAL and CysC in both groups decreased significantly (P < 0.05), but there were no significant differences in indicators mentioned above between the two groups (P>0.05). After treatment, the levels of CRP, IL-6 and TNF-α in both groups increased significantly, but the levels of CRP, IL-6 and TNF-α in the UMP group were significantly lower than those in the PCNL group (P < 0.05). After treatment, the levels of Cor, NE and ACTH in both groups increased significantly, but the levels of Cor, NE and ACTH in the UMP group were significantly lower than those in the PCNL group (P < 0.05). The incidence of complications in the UMP group was 7.27%, which was significantly lower than 23.08% in the PCNL group (P < 0.05). At 6 months after surgery, the recurrence rate in the UMP group was 1.82%, which was significantly lower than 11.54% in the PCNL group (χ²=4.131, P=0.042).

Conclusion For renal calculus patients complicated with diabetes mellitus, implementation of UMP treatment can increase the stone clearance rate, alleviate the postoperative stress response and inflammatory reactions and reduce recurrence rate of stone, so it is worthy of popularization and promotion.