A Comparative Analysis between Flexible Ureteroscopic Lithotripsy and Tubeless Percutaneous Nephrolithotomy in the Treatment of >15 mm Non-Obstructing Proximal Ureteral Stones.

Autor: Choi YS; Department of Urology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea., Sorkhi SR; VA Medical Center San Diego, VA San Diego Healthcare System, San Diego, CA 92161, USA., Cho HJ; Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea., Kim KS; Department of Urology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu 11765, Republic of Korea.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Dec 07; Vol. 12 (24). Date of Electronic Publication: 2023 Dec 07.
DOI: 10.3390/jcm12247541
Abstrakt: Background: The proper surgical modality for large non-obstructing proximal ureteral stones is disputed. We compare effectiveness and safety of flexible ureteroscopic lithotripsy (FURL) and tubeless percutaneous nephrolithotomy (TPNL) in treatment of upper ureteral stones larger than 1.5 cm.
Methods: We reviewed the medical records of patients who performed FURL or TPNL for upper ureteral stones between June 2016 and November 2018. Comparative analysis was conducted regarding demographic parameters, stone free rate, postoperative pain and complications.
Results: This study included 58 patients treated with FURL and 60 patients treated with TPNL owing to upper ureteral stones larger than 1.5 cm. Stone size was similar in the FURL and TPNL groups (17.6 ± 2.6 vs. 18.0 ± 2.1 mm, p = 0.194). The overall 3-month stone clearance rate was 95.8% for FURL versus 96.0% for TPNL ( p = 0.575). There was no difference between the FURL and TPNL groups for hospital stay ( p = 0.280) and postoperative complications. On the other hand, patients treated with FURL had longer operative time ( p = 0.012) and less postoperative pain ( p = 0.008).
Conclusions: Both surgical techniques were considered feasible and effective surgical procedures in the treatment of large upper ureteral stones.
Databáze: MEDLINE
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