Comparison between Mini-Percutaneous Nephrolithotomy and Flexible Ureteroscopy for Patients with Upper Calyceal Calculi Larger than 2 cm.

IF 0.9 4区医学 Q4 UROLOGY & NEPHROLOGY

Archivos Espanoles De Urologia Pub Date : 2025-07-01 DOI:10.56434/j.arch.esp.urol.20257806.88

Zafer Gokhan Gurbuz, Kadir Karkin, Mubariz Aydamirov, Bugra Aksay, Ediz Vuruskan

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Abstract

Background: This study aimed to compare the results of flexible ureteroscopy with holmium laser lithotripsy (FURSL) and mini-percutaneous nephrolithotomy (mini-PNL) for the treatment of >2 cm upper calyceal stones.

Methods: The data of patients who underwent FURSL and mini-PNL surgery for kidney stones between May 2011 and June 2023 were retrospectively examined. Patients with single or multiple kidney stones located in the upper calyx and varying in diameter from 2 cm to 4 cm were included in the study. Operation time, hospitalisation time, complication rates and 1 month stone-free rate (SFR) were compared between the two surgical methods. Stone-free status was evaluated by performing non-contrast computed tomography 1 month after the surgery.

Results: A total of 73 (49.3%) and 75 (50.7%) patients were included in the FURSL and mini-PNL groups, respectively. The mean operation time (72.5 vs. 89.7 min) and hospital stay (1.2 vs. 2.1 days) were shorter in the FURSL group (p < 0.001). Although complications were less common in the FURSL group, the difference was not statistically significant (12.3% vs. 21.3%, p = 0.199). The 1 month SFRs were 83.6% and 90.7% in the FURSL and mini-PNL groups, respectively, without statistically significant difference between the groups (p = 0.461).

Conclusions: Both surgical approaches are equally effective and safe for the treatment of >2 cm upper calyceal stones. Short surgery and hospitalisation times are the most important advantages of FURSL. This type of surgery can be recommended as an alternative treatment to mini-PNL, with lower complication rates in selected patients.

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微型经皮肾镜取石术与输尿管软镜治疗大于2cm上盏结石的比较。

背景：本研究旨在比较输尿管软镜下钬激光碎石术（FURSL）和微型经皮肾镜取石术（mini-PNL）治疗上肾盏结石的效果。方法：回顾性分析2011年5月至2023年6月期间接受FURSL和mini-PNL手术治疗肾结石患者的资料。单个或多个肾结石位于上肾盏，直径从2厘米到4厘米不等的患者被纳入研究。比较两种手术方式的手术时间、住院时间、并发症发生率及1个月无结石率（SFR）。术后1个月通过非对比计算机断层扫描评估无结石状态。结果：FURSL组73例（49.3%），mini-PNL组75例（50.7%）。FURSL组的平均手术时间（72.5 min vs. 89.7 min）和住院时间（1.2 d vs. 2.1 d）均较短（p < 0.001）。虽然FURSL组并发症发生率较低，但差异无统计学意义（12.3%比21.3%,p = 0.199）。FURSL组和mini-PNL组1个月生存率分别为83.6%和90.7%，组间差异无统计学意义（p = 0.461）。结论：两种手术入路治疗肾上盏结石均安全有效。手术和住院时间短是FURSL最重要的优势。这种类型的手术可以推荐作为迷你pnl的替代治疗方法，在选定的患者中并发症发生率较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archivos Espanoles De Urologia UROLOGY & NEPHROLOGY-

CiteScore

0.90

自引率

0.00%

发文量

111

期刊介绍： Archivos Españoles de Urología published since 1944, is an international peer review, susbscription Journal on Urology with original and review articles on different subjets in Urology: oncology, endourology, laparoscopic, andrology, lithiasis, pediatrics , urodynamics,... Case Report are also admitted.