A Retrospective Study of 205 Patients with Complex Kidney Stones to Compare Outcomes from Super-Mini Percutaneous Nephrolithotomy Combined with Flexible Ureteroscopic Lithotripsy with Flexible Ureteroscopic Lithotripsy Alone

Background:This retrospective study aimed to compare outcomes from super-mini percutaneous nephrolithotomy (SMP) combined with flexible ureteroscopic lithotripsy (FURL) and FURL alone in 205 patients with 2.5-4.2cm diameter complex kidney stones. Material/Methods:Between January 2018 and December 2022, 92 patients were treated with SMP combined with FURL (group A), and 113 patients were treated with FURL alone (group B).The stone-free rate (SFR), retreatment ratio, operation time, mean decline in hemoglobin level, postoperative pain visual analogue scale (VAS), and postoperative hospitalization time and complications were analyzed and compared between the 2 groups. Results:The SFR 3 days after the operation was 85.87% in group A, which was significantly higher than that in group B (72.57%) (P=0.021).The rate of retreatment in group A (3.26%) was significantly lower than that in group B (10.62%) (P=0.044).The SFR after 90 days was higher in group A (94.57%) than in group B (90.27%) (P=0.254).The mean decrease in hemoglobin, postoperative hospitalization duration, and VAS score 6 hours after the operation were all significantly higher in group A than in group B (P<0.05).However, there was no significant difference in operation time, VAS score at 12 and 24 hours after the operation, and complication rate. Conclusions:In the treatment of complex renal stones, compared with FURL, SMP combined with FURL in the oblique supine lithotomy position has the advantages of a higher early SFR with no increased risk of complications.