For a study, researchers sought to evaluate the efficacy of flexible ureteroscopy and lasertripsy versus mini percutaneous nephrolithotomy (PNL) in treating upper calyceal calculi measuring more than 2 centimeters in diameter. A retrospective analysis was performed on 75 patients with upper calyceal calculi bigger than 2 cm who were treated with either FURSL (n=37) or mini-PNL (n=38). Comparisons were made between the 2 groups in terms of mean age, sex, stone burden, surgical time, complications, length of hospitalization, and stone-free rate (SFR). The operation was considered successful if, after 4 weeks, computed tomography showed no signs of residual stones or residual pieces less than 4 mm.
Preoperative values were similar across the 2 groups. Mini-PNL patients required more time in surgery (87.8 vs. 69.8 min, P<0.001) than FURSL patients. Mini-PNL patients spent significantly longer in the hospital than in the FURSL group (2.5 vs. 1.3 days, P<0.001). Statistical analysis showed that there was no statistically significant difference between the mini-PNL group (23.7%) in the FURSL group (13.5%) when it came to the rate of perioperative complications (P=0.258), even though the mini-PNL group experienced a greater rate of complications. Notably, there was no statistically significant difference between the mini-PNL group 89.5%, and the FURSL group was 81.1% in terms of SFR (P=0.304).
Those with upper calyceal calculi greater than 2 cm have a choice between FURSL and mini-PNL, both of which are effective and safe. Mini-PNL takes less time, but FURSL is linked to a quicker recovery time. In some cases, FURSL may be a viable alternative therapy option.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-022-01142-0
