Effects of micro-channel negative pressure sheath percutaneous nephrolithotomy versus extracorporeal shock wave lithotripsy for renal stones: risk factors for postoperative complications

微通道负压鞘经皮肾镜取石术与体外冲击波碎石术治疗肾结石的效果比较:术后并发症的危险因素

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Abstract

OBJECTIVE: To compare the effects of micro-channel negative pressure sheath percutaneous nephrolithotomy (mPCNL) and extracorporeal shock wave lithotripsy (ESWL) in the treatment of renal stones and analyze risk factors for postoperative complications. METHODS: A retrospective analysis was conducted on 120 patients with renal stones treated at Beijing Friendship Hospital from January 2023 to December 2024. Patients were divided into two groups: control (ESWL, n=60) and observation (mPCNL, n=60). Clinical efficacy, renal injury markers, inflammatory factors, oxidative stress markers, quality of life, and complications were compared. Risk factors for complications were assessed by dividing patients into good and poor outcome groups based on complications within 30 days post-surgery. RESULTS: The observation group showed a significantly higher clinical efficacy rate than the control group (P<0.05). Renal injury and inflammatory markers increased 24 hours post-surgery in both groups, with the control group showing a more significant rise. Oxidative stress markers also showed a greater change in the control group (P<0.05). At 30 days post-surgery, quality of life improved more significantly in the observation group (P<0.05). The total complication rate was lower in the observation group (P<0.05). Multivariate analysis identified age, surgical method, stone diameter, catheter indwelling time, renal insufficiency, and diabetes as independent risk factors for complications (all P<0.05). CONCLUSION: mPCNL was more effective than ESWL for renal stones treatment, with fewer complications and greater quality of life improvement. Age, surgical method, and stone diameter were independent risk factors for postoperative complications.

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