Comparison of flexible ureteroscopy lithotripsy and percutaneous nephrolithotomy in the treatment of 2-3cm renal calculi

Objective To compare the clinical effectiveness of flexible ureteroscopy lithotripsy (FURL) and percutaneous nephrolithotomy (PCNL) in the treatment of 2-3 cm renal calculi. Methods A total of 298 renal calculus patients (with a diameter of 2-3 cm) in the Affiliated Hospital of Xuzhou Medical University from July 2017 to May 2020 were enrolled and their clinical data was retrospectively analyzed. Then, 146 patients receiving FURL were set as an observation group and 152 patients treated with PCNL were set as a control group. The stone size and location, the number of stones, body mass index (BMI), counts of hemoglobin (Hb) and white blood cells (WBC) and creatinine (Cr) value were determined. The duration of operation, postoperative complications, postoperative length of hospitalization stay, total expense and stone clearance rate were recorded. Results The decrease of hemoglobin counts 24 h after operation, postoperative length of hospitalization stay and the incidence of complications were lower in the observation group than in the control group (P<0.05). The duration of operation and hemoglobin counts 24 h after operation were higher in the observation group than in the control group (P<0.05). The stone clearance rate in the lower calyx was lower in the observation group than in the control group (P<0.05) . Conclusions Both FURL and PCNL are effective in the treatment of 2-3 cm calculi in the upper and middle calyx. FURL presents less blood loss and postoperative complications, which is more consistent with the conception of enhanced recovery after surgery and worthy of application.