Results
Total 784 patients were analyzed retrospectively and the characteristics of the patients and the stone were showed in Table 1. The FURSL operation was performed successfully in all patients. Peri-operative data were summarized in Table 2. The mean operating time was 46.9±15.8 minutes and post-operative hospital stay was 1.2±1.1 days. Meanwhile, we compared the serum creatinine and hemoglobin before and after the operation, and no significant differences were observed. No severe bleeding and acute renal failure were observed.
Complications were classified as intra-operative and post-operative and summarized in Table 2. Ureter injure is the main complication during the operation, which is caused by the ureteral access sheath entering the ureter. In this study, mild ureteral injury and renal pelvis perforation occurred in 7 cases and 1 case respectively. No ureteral rupture or tearing were not observed. After the operation, fever and ipsilateral low back pain were observed in 58 cases and 47 cases respectively, which were cured by the additional antibiotic and drug treatment. During the follow-up period, gross hematuria(540/784,68.88%) is the main common post-operative complication, most of which are improved significantly after conservative treatment. Renal subcapsular hematoma after the FURSL operation were identified in five patients, which was cured after symptomatic treatment such as antibiotic and hemostasis. The incidence of septic shock was very low and only 5 cases occurred, who recovered after active and effective treatment in intensive care unit (ICU). All patients received the KUB examination at 1 day and 1 month postoperatively respectively. Also, urinary system ultrasound was performed in all patients at 1 month after the operation. No patients were lost to follow-up. The SFR of one day and one month postoperatively were 66.2% and 92.5% respectively. Compared to 1 day postoperatively, the SFR were significant high at 1 month postoperatively.
Three months after operation, 746 cases were followed up and 38 patients were lost. Three months after operation, there was 700(93.8%) cases and 46 cases(6.2%) in stone clearance group and residual stone group,repectively. In the residual stone group, 25 cases were re-treated with the FURSL, 10 cases and 21 cases were treated with ESWL and observation repectively after removal of double J stent. The diameter of stones in the stone clearance group and the residual stone group were (1.6 ± 0.3) cm and (2.1 ± 0.8) cm, respectively, which show the significant difference. There were 608 (81.5%) and 21 (2.81%) cases with stones less than 2cm in diameter, and 92 (12.33%) and 25 (3.35%) cases with stones more than 2 cm in diameter in both group, respectively. The difference between two groups was statistically significant. Meanwhile, there were 81 cases (11.57%) and 38 cases (5.43%) of lower calyceal calculi, 619 cases (82.98%) and 8 cases (1.07%) of non lower calyceal calculi in stone clearance group and residual stone group, respectively, which showed the significant statistically difference.