Objective To compare and evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotomy( MPCNL )and standard puncture passage percutaneous nephrolithotomy( PCNL ) in the treatment of complicated upper ureteral calculi. Methods A retrospective analysis was reviewed in 62 cases of complicated upper ureteral calculi, including 38 cases of MPCN and 24 cases of PCNL. The operation time, postoperative hospital stay, stone-free rate, estimated intraoperative blood loss, amount of per-fusion liquid and incidence of operative complications were measured statistically and compared between the two groups. Results In all the 62 cases,the nephrostomy tract was established and the operations were performed successfully under one-stage. Significant differences between MPCNL and PCNL group were not observed in operation time, postoperative hospital stay, stone-free rate, amount of perfusion liquid, except estimated intraoperative blood loss( 54. 6 ± 14. 8 ml vs. 103. 0 ± 92. 7 ml,P ＜0. 05 ) or incidence of operative complications( 5. 26 % vs. 25. 00 % , P ＜ 0. 05 ). In the PCNL group, there was 1 case of channel loss,l case of ureteral perforation and 4 cases of fever,in which the postoperative temperature was aboved 38. 5℃. In the MPCNL group only 2 patients' postoperative temperature was above 38. 5℃. Conclusion Both MPCNL and PCNL are effective therapies for complicated upper ureteral calculi. Moreover, MPCNL has the advantage of little blood loss and low incidence of complications, which is safer for the patients.%目的 比较和评价微通道与标准通道经皮肾镜治疗复杂性输尿管上段结石的临床疗效及安全性.方法 回顾性分析经皮肾镜治疗复杂性输尿管上段结石62例的临床资料,其中采用微通道38例、标准通道24例,比较两组手术时间、术后住院时间、结石清除率、术中估计出血量、术中灌注液用量、并发症发生率等指标.结果 62例患者均一期成功建立经皮肾通道,对比两组手术时间、术后住院时间、结石清除率、术中灌注液用量,差异均无统计学意义(P>0.05).术中微通道与标准通道估计出血量分别为(54.6±14.8)ml、(103.0±92.7)ml,差异有统计学意义(P＜0.05).标准通道组术中1例在寻找残石时通道丢失;1例发生输尿管穿孔;4例术后体温＞38.5℃.微通道组术后2例体温＞38.5℃.微通道与标准通道并发症发生率分别为5.26%、25.00%,差异有统计学意义(P＜0.05).结论 在治疗复杂性输尿管上段结石时,微通道具有和标准通道相同的满意疗效,微通道出血少、并发症发生率低,更为安全.
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