Suctioning semirigid ureteroscopic lithotomy versus minimally invasive percutaneous nephrolithotomy for large upper ureteral stones: a retrospective study

Abstract

Background: To compare the safety and validity of a suctioning semirigid ureteroscopic lithotomy (Sotn-URSL) and minimally percutaneous nephrolithotomy (mPCNL) in treating upper ureteral stone larger than 15 mm. Methods: Between February 2018 and December 2019, 97 patients who had upper ureteral stone >15 mm were consecutively included in this study. Forty-six patients underwent Sotn-URSL and 51 underwent mPCNL by the same surgeon. The following parameters were retrospectively assessed: patient and stone characteristics, surgical details, perioperative outcomes, and stone-free rates (SFRs).Results: No significant difference was observed in two groups for patient and stone characteristics, except that mPCNL group had a higher incidence of severe hydronephrosis (19.6% vs. 41.2%, P=0.021). Sotn-URSL group was similar to mPCNL group in terms of the mean duration of surgery (50.5±5.9 vs. 52.9± 8.0 min, P=0.106) and the SFR after 1 month (91.3% vs. 98%, P=0.187). The hospital stay after surgery of Sotn-URSL group was significant shorter than mPCNL group (1.4±0.6 vs. 2.3±0.7 days, P<0.001), and postoperative complications in Sotn-URSL group was less, especially postoperative pain (P=0.044).Conclusions: Both mPCNL and Sotn-URSL are suitable for upper ureteral stones with a diameter of >15 mm. Nevertheless, further well-designed studies with long-term follow-up are needed to confirmed the results.

WITHDRAWN: Comparison of vacuum suction semirigid ureteroscopic laser lithotripsy and flexible ureteroscopic laser lithotripsy for upper ureteral calculi with a diameter ≥ 15mm: a retrospective study

“…It integrates the bene ts of vacuum suction and perfusion in the UAS to achieve simultaneous lithotripsy and stone removal, lower intra-renal pressure, and clear surgical elds. It has recently been shown that Sotn-URS is a safe and effective treatment for renal pelvic stones and proximal ureteral stones [9,10] . Based on the "simultaneous lithotripsy and stone removal" feature of Sotn-URS, it may theoretically have an advantage over F-URS in the treatment of larger upper ureteral stones.…”

Comparison Between Retrograde and Antegrade Ureteroscopic Laser Lithotripsy for the Management of Medium-Sized Proximal Ureteral Stones: A Randomized Prospective Study

“…Although there was no statistically significant difference between the two groups (p = 0.098), Chen et al discovered that the SFR after one month in the mPCNL group was 50/51, or 98%, while in the URL group, it was 89.1% (41/46) [6]. In terms of the SFR, the present analysis indicated a statistically insignificant difference between the groups.…”

“…Consistent with these results, Abdeldaeim et al reported that the mini-percutaneous nephrolithotomy group displayed a markedly higher mean postoperative reduction in hemoglobin concentration (0.47 gm vs. 0.2 gm) (p < 0.001) [7]. According to the research conducted by Chen et al, three patients from the mPCNL group required blood transfusions due to a significant drop in their hemoglobin levels [6]. Wang et al also found that PCNL, compared to semirigid URL, increased the risk of bleeding and hematuria, often necessitating blood transfusions [8].…”

“…After antegrade URS, the median duration of hospitalization was two days, but following retrograde URS, it was one day (p = 0.001). Furthermore, it was discovered by Chen et al that the average duration of hospital stay after surgery was significantly reduced in the URSL group (1.4 ± 0.6 vs. 2.3 ± 0.7; p < 0.001) [6].…”

“…In our study, a statistically significant difference in the level of hydronephrosis was observed between the two groups under investigation (p = 0.008), aligning with the findings of Chen et al's study. In their research, 46 cases underwent ureteroscopic lithotripsy (URSL), while 51 cases underwent minimally invasive percutaneous nephrolithotomy (MPCNL) (p = 0.021) [6]. A potential major contributing factor to this observed difference could be the presence of case selection bias.…”