Comparison of the efficacy of combined nephrostomy and conventional flexible lithotripsy in the treatment of complex upper ureteral stones

This study compares the clinical efficacy of nephrostomy combined with flexible ureteroscopy versus conventional flexible ureteroscopy for complex upper ureteral stones. The clinical data of 68 patients with unilateral complex upper ureteral stones admitted to the Hospital Affiliated to Shaoxing College of Arts and Sciences from April 2021 to September 2023 were retrospectively analyzed, and they were divided into 2 groups according to whether or not they had undergone nephrostomy before lithotripsy, with 34 in each group; the experimental group was treated with nephrostomy combined with flexible ureteroscopy lithotripsy (FURL), and the control group was treated with FURL. The stone removal rate, operation time, intraoperative bleeding and complications of the 2 groups were compared. All patients successfully completed the treatment. The stone clearance rate was 94.1% in the experimental group and 76.5% in the control group; the operation time was (48.97 ± 14.25) min and (63.35 ± 17.76) min, respectively; intraoperative bleeding was (32.8 ± 6.1) ml and (53.4 ± 5.9) ml, respectively; serum creatinine at 3 days after operation was (89.7 ± 9.3) μmol/L and (96.1 ± 9.9) μmol/L; postoperative hospitalization days were (3.65 ± 0.98) day and (4.41 ± 1.28) day, respectively. Nephrostomy combined with flexible lithotripsy and conventional flexible lithotripsy are both safe and effective in the treatment of complex upper ureteral stones, but nephrostomy combined with flexible lithotripsy has a higher stone clearance rate, less intraoperative bleeding, and shorter operative time, which is worthy of clinical promotion.