Xi Xie, Guoping Xie, Wei Li, Kazumi Taguchi, Bhaskar Somani, Yuan Yuan, Bo Li
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To this end, we designed this study to compare the effects of mini-PCNL versus fURSL in patients with upper ureteral impacted stones with infection.</p><p><strong>Methods: </strong>The data of 182 patients with upper ureteral impacted stones and infection admitted to The First Affiliated Hospital of Chengdu Medical College from January 2021 to December 2024 were retrospectively collected. The patients were divided into an antegrade group (n=88) and a retrograde group (n=94) according to the method they received. The antegrade group was treated with minimally invasive PCNL, and the retrograde group was treated with fURSL. The main outcome measure included inflammatory markers [white blood cell count (WBC), C-reactive protein, interleukin 6, and procalcitonin], and renal function (serum creatinine and urea nitrogen). The other indicators included surgery-related outcomes (operation time and stone-free status) and postoperative complications.</p><p><strong>Results: </strong>Compared with the retrograde group, the one-time stone clearance rate in the antegrade group was significantly higher (96.59% <i>vs.</i> 86.17%; P=0.03). Compared with that in the retrograde group, the operation time in the antegrade group was significantly longer (62.73±4.82 <i>vs.</i> 51.84±5.02 min; P<0.001). There were no statistically significant differences in leukocyte, C-reactive protein, or interleukin 6 levels between the two groups before treatment (P>0.05). Compared to the retrograde group 3 days after surgery, the antegrade group had a significantly higher WBC [(10.92±2.88 <i>vs.</i> 8.92±2.62)×10<sup>9</sup>/L; P<0.001], C-reactive protein (12.94±4.72 <i>vs.</i> 10.82±4.82 mg/L; P=0.003), and interleukin 6 level (18.74±9.82 <i>vs.</i> 15.81±9.27 ng/L; P=0.04). There was no statistically significant difference in postoperative complications between the two groups (P>0.05).</p><p><strong>Conclusions: </strong>PCNL can improve stone clearance rate, but the operation time is long and relatively invasive.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2375-2382"},"PeriodicalIF":1.7000,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433165/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of the effects of mini-percutaneous nephrolithotomy versus flexible ureteroscopic lithotripsy in patients with upper ureteral impacted stones with infection.\",\"authors\":\"Xi Xie, Guoping Xie, Wei Li, Kazumi Taguchi, Bhaskar Somani, Yuan Yuan, Bo Li\",\"doi\":\"10.21037/tau-2025-277\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Urinary stones are a common disease in urology, and stones in ureteral strictures can easily lead to obstruction and subsequent infection. If the upper ureteral impacted stones with infection are not treated promptly, further renal impairment and urinary sepsis can occur. Mini-percutaneous nephrolithotomy (PCNL) and flexible ureteroscopic lithotripsy (fURSL) are common methods for the treatment of upper ureteral impacted stones with infection, but their superiority remains debated. To this end, we designed this study to compare the effects of mini-PCNL versus fURSL in patients with upper ureteral impacted stones with infection.</p><p><strong>Methods: </strong>The data of 182 patients with upper ureteral impacted stones and infection admitted to The First Affiliated Hospital of Chengdu Medical College from January 2021 to December 2024 were retrospectively collected. The patients were divided into an antegrade group (n=88) and a retrograde group (n=94) according to the method they received. The antegrade group was treated with minimally invasive PCNL, and the retrograde group was treated with fURSL. The main outcome measure included inflammatory markers [white blood cell count (WBC), C-reactive protein, interleukin 6, and procalcitonin], and renal function (serum creatinine and urea nitrogen). The other indicators included surgery-related outcomes (operation time and stone-free status) and postoperative complications.</p><p><strong>Results: </strong>Compared with the retrograde group, the one-time stone clearance rate in the antegrade group was significantly higher (96.59% <i>vs.</i> 86.17%; P=0.03). Compared with that in the retrograde group, the operation time in the antegrade group was significantly longer (62.73±4.82 <i>vs.</i> 51.84±5.02 min; P<0.001). There were no statistically significant differences in leukocyte, C-reactive protein, or interleukin 6 levels between the two groups before treatment (P>0.05). Compared to the retrograde group 3 days after surgery, the antegrade group had a significantly higher WBC [(10.92±2.88 <i>vs.</i> 8.92±2.62)×10<sup>9</sup>/L; P<0.001], C-reactive protein (12.94±4.72 <i>vs.</i> 10.82±4.82 mg/L; P=0.003), and interleukin 6 level (18.74±9.82 <i>vs.</i> 15.81±9.27 ng/L; P=0.04). 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引用次数: 0
摘要
背景:尿路结石是泌尿外科的常见病,输尿管狭窄处的结石易导致梗阻和继发感染。如果不及时治疗感染的上输尿管嵌塞结石,可能会发生进一步的肾功能损害和尿脓毒症。微型经皮肾镜取石术(PCNL)和柔性输尿管镜碎石术(fURSL)是治疗输尿管上段梗阻结石并感染的常用方法,但其优越性仍存在争议。为此,我们设计了这项研究,比较mini-PCNL和fURSL在输尿管上段梗阻结石感染患者中的效果。方法:回顾性收集成都医学院第一附属医院2021年1月至2024年12月收治的182例输尿管上段梗阻结石及感染患者的资料。根据治疗方法分为顺行组(88例)和逆行组(94例)。顺行组行微创PCNL治疗,逆行组行fURSL治疗。主要结局指标包括炎症标志物[白细胞计数(WBC)、c反应蛋白、白细胞介素6和降钙素原]和肾功能(血清肌酐和尿素氮)。其他指标包括手术相关结果(手术时间和无结石状态)和术后并发症。结果:与逆行组比较,顺行组一次性结石清除率明显高于逆行组(96.59% vs. 86.17%, P=0.03)。顺行组手术时间明显长于逆行组(62.73±4.82 min∶51.84±5.02 min; P0.05)。术后3 d,顺行组WBC明显高于逆行组(10.92±2.88 vs 8.92±2.62)×109/L;Pvs 10.82±4.82 mg/L;P=0.003),白细胞介素6水平(18.74±9.82∶15.81±9.27 ng/L; P=0.04)。两组术后并发症发生率比较,差异无统计学意义(P < 0.05)。结论:PCNL术可提高结石清除率,但手术时间长且有一定的侵入性。
Comparison of the effects of mini-percutaneous nephrolithotomy versus flexible ureteroscopic lithotripsy in patients with upper ureteral impacted stones with infection.
Background: Urinary stones are a common disease in urology, and stones in ureteral strictures can easily lead to obstruction and subsequent infection. If the upper ureteral impacted stones with infection are not treated promptly, further renal impairment and urinary sepsis can occur. Mini-percutaneous nephrolithotomy (PCNL) and flexible ureteroscopic lithotripsy (fURSL) are common methods for the treatment of upper ureteral impacted stones with infection, but their superiority remains debated. To this end, we designed this study to compare the effects of mini-PCNL versus fURSL in patients with upper ureteral impacted stones with infection.
Methods: The data of 182 patients with upper ureteral impacted stones and infection admitted to The First Affiliated Hospital of Chengdu Medical College from January 2021 to December 2024 were retrospectively collected. The patients were divided into an antegrade group (n=88) and a retrograde group (n=94) according to the method they received. The antegrade group was treated with minimally invasive PCNL, and the retrograde group was treated with fURSL. The main outcome measure included inflammatory markers [white blood cell count (WBC), C-reactive protein, interleukin 6, and procalcitonin], and renal function (serum creatinine and urea nitrogen). The other indicators included surgery-related outcomes (operation time and stone-free status) and postoperative complications.
Results: Compared with the retrograde group, the one-time stone clearance rate in the antegrade group was significantly higher (96.59% vs. 86.17%; P=0.03). Compared with that in the retrograde group, the operation time in the antegrade group was significantly longer (62.73±4.82 vs. 51.84±5.02 min; P<0.001). There were no statistically significant differences in leukocyte, C-reactive protein, or interleukin 6 levels between the two groups before treatment (P>0.05). Compared to the retrograde group 3 days after surgery, the antegrade group had a significantly higher WBC [(10.92±2.88 vs. 8.92±2.62)×109/L; P<0.001], C-reactive protein (12.94±4.72 vs. 10.82±4.82 mg/L; P=0.003), and interleukin 6 level (18.74±9.82 vs. 15.81±9.27 ng/L; P=0.04). There was no statistically significant difference in postoperative complications between the two groups (P>0.05).
Conclusions: PCNL can improve stone clearance rate, but the operation time is long and relatively invasive.
期刊介绍:
ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.