JANUARY 2024
Comparative Analysis of Treatment Outcomes between Flexible Ureteroscopy and Mini-Percutaneous Nephrolithotomy for Upper Calyceal Calculi Larger than 2 cm
1Dr Yassar Hussain Patujo, 2Dr Sajid Ali Abbasi, 3Dr Reena Nawaz, 4Dr Sanaullah maitlo, 5Dr Sumera Brohi
1Assistant professor dept of urology, Shaheed mohtarma Benazir Bhutto medical university larkana
2Assistant professor dept of urology, Shaheed mohtarma Benazir Bhutto medical university larkana
3Consultant urologist, Cmc hospital Larkana
4Consutlat urologist, Gmmmc hospital sukkur
5Consultant gynaecologist & obstetrician, Shaikhzaid women hospital CMC Larkana
ABSTRACT
Background: The management of upper calyceal calculi larger than 2 cm presents the clinical challenge, with various minimally invasive techniques available. Among these, flexible ureteroscopy (FURS) and mini-percutaneous nephrolithotomy (mini-PNL) have emerged as effective options. However, comparative studies evaluating their treatment outcomes are scarce, warranting further investigation.
Aim: This prospective study aimed to associate treatment results of flexible ureteroscopy (FURS) and mini-percutaneous nephrolithotomy (mini-PNL) for upper calyceal calculi larger than 2 cm.
Methods: Individuals having upper calyceal calculi larger than 2 cm who underwent either FURS or mini-PNL between November 2022 and October 2023 were involved in research. Baseline demographic data, stone characteristics, perioperative variables, and postoperative outcomes were composed and studied. Statistical analysis was performed to associate stone clearance rates, complication rates, operative times, and hospital stays among two sets.
Results: An overall of 80 individuals were registered in research, having 40 individuals in each treatment group. The mean operative time was 75 minutes (SD ± 10) in FURS group and 60 minutes (SD ± 8) in Mini-PNL group. Stone clearance rate was 85% (95% CI, 80-90) in the FURS group and 95% (95% CI, 90-100) in the Mini-PNL group. Complication rates were comparable between the two sets, with minor difficulties observed in 10% (95% CI, 5-15) of patients in FURS group and 8% (95% CI, 3-13) in the Mini-PNL group. No key problems were reported in either set.
Conclusion: In management of upper calyceal calculi larger than 2 cm, both flexible ureteroscopy (FURS) and mini-percutaneous nephrolithotomy (mini-PNL) are effective treatment modalities. Mini-PNL demonstrated superior stone clearance rates, while FURS exhibited advantages in terms of lower difficulty rates and shorter operative times. The choice between these modalities should be tailored to individual patient characteristics and surgeon expertise.
Keywords: flexible ureteroscopy, mini-percutaneous nephrolithotomy, upper calyceal calculi, treatment outcomes, comparative analysis