Clinical comparative study of standard channel percutaneous nephroscope combined with flexible ureteroscope and traditional standard channel combined with microchannel percutaneous nephrolithotomy in the treatment of multiple renal calculi without hydronephrosis

Objectives: To evaluate the clinical efficacy of standard channel percutaneous nephroscope combined with flexible ureteroscope and traditional standard channel combined with microchannel percutaneous nephrolithotomy in the treatment of multiple renal calculi without hydronephrosis. Methods: Eighty patients with multiple renal calculi without hydronephrosis treated in Shijiazhuang People’s Hospital from January 2020 to October 2021 were randomly divided into two groups: the experimental group and the control group, with 40 cases in each group. Patients in the experimental group were treated with standard channel percutaneous nephroscope combined with flexible ureteroscopy lithotripsy, while those in the control group were treated with standard channel combined with microchannel percutaneous nephrolithotomy. The differences in operative time, postoperative hospital stay, intraoperative blood loss, calculus clearance rate, and number of channels between the two groups were compared and analyzed. Moreover, the changes of renal function indexes such as serum creatinine, urea nitrogen, blood β 2-microglobulin and blood uric acid were compared and analyzed between the two groups postoperatively; Renal static imaging technology was utilized to compare and analyze the renal parenchymal injury of the two groups postoperatively. The incidence of surgical complications such as pain, fever, urine leakage at the incision, chest tightness and chest pain within 72h postoperatively was compared and analyzed between the two groups. Results: The operative time, postoperative hospital stay and intraoperative blood loss in the experimental group were significantly lower than those in the control group, with statistically significant differences (P=0.00). The number of percutaneous renal channels established in the experimental group was significantly superior to that of the control group (P=0.00); No statistically significant difference can be seen in the calculus clearance rate between the two groups (P=0.17); Postoperative TNF-a, CRP, IL-6 and other inflammatory factors in the experimental group were significantly lower than those in the control group (TNF-a, CRP, P=0.00; Il-6, P=0.01), and cortisol level in the experimental group was significantly lower than that in the control group, which was statistically significant (P=0.00). Postoperative renal static imaging showed that the degree of renal injury in the experimental group was lower than that in the control group (P=0.00). No statistically significant difference was observed in renal function indexes such as serum creatinine, urea nitrogen, blood β2-microglobulin and blood uric acid between the two groups (P>0.05). Conclusion: Standard channel percutaneous nephroscope combined with flexible ureteroscope is a safe and effective treatment regimen for the treatment of multiple renal calculi without hydronephrosis, boasting of numerous advantages such as reduced number of channels, less bleeding, short operative time, low kidney injury, low impact on internal environmental factors such as inflammation and stress in the patients, short postoperative hospital stay, and low incidence of complications.