微创经皮肾镜与输尿管镜治疗输尿管上段结石的疗效比较

Comparison of Minimally Invasive Percutaneous Nephrolithotomy and Ureteroscopy in the Management of Upper Ureteral Stone

目的:比较微创经皮肾镜取石术和输尿管镜取石术治疗输尿管上段结石的手术效果及并发症。方法:采用微创经皮肾镜和输尿管镜治疗57例输尿管上段结石患者,平均结石体积分别为(237.3±90.8)mm^2和(155.8±63.7)mm^2,比较术后结石清除率和并发症发生率等数据。结果:所有患者均耐受手术,无严重并发症发生,经皮肾镜组和输尿管镜组结石清除率分别为90.6%和68%,并发症发生率分别为21.9%和0.4%。结论:输尿管镜具有创伤小,恢复快等特点,但结石清除率低,术后常需辅助方法进一步清除残石。经皮肾镜取石术治疗输尿管上段结石清除率高,但创伤较大,并发症发生率高。

Objective： To compare treatment outcomes and complications by minimally invasive percutaneous nephrolithotomy （MPCNL） and ureteroscopic lithotripsy （URSL）. Methods： A total of 57 patients with upper ureteral stones had undergone MPCNL or URSL treatment. Stone burdens in the MPCNL and URSL groups were （237.3±90.8） mm^2 and （155.8±65.7） mm^2, respectively. The stone-free rate and the incidence of complications were compared. Results： All of patients tolerated operations without severe complications. The stone-free rate of the MPCNL and URSL groups were 90.6% and 68%, the incidence of complications were 21.9% and 0.4%, respectively. Conelusions：URSL had the advantages of minimal invasion and shorter recovery time, but with the low stone-free rate. The patients often needed auxiliary procedure to clear residual stones. MPCNL had better stone-free rates hut the operation was more invasive and had high complication rate.