Applications of flexible ureteroscope lithotripsy with negative pressure suction and percutaneous nephrolithotomy in the treatment of 2-3 cm diameter renal calculi.

Background: Renal calculus, or kidney stone disease, presents a significant healthcare challenge globally, necessitating diverse therapeutic interventions. Percutaneous nephrolithotomy (PCNL) and flexible ureteroscope lithotripsy (FURL) are prominent among these interventions, with PCNL favored for stones > 2 cm and FURL for smaller stones and applications of flexible ureteroscope lithotripsy with negative pressure suction for stones 1.5-2.5 cm have some benefit.

Methods: From June 2019 to January 2024, 310 patients undergoing FURL with negative pressure suction or PCNL for 2-3 cm renal calculi were retrospectively analyzed. The demographic and clinical data were collected, and outcomes including stone-free rates (SFR), postoperative complications, and surgical parameters were compared.

Results: Comparable SFR were observed between FURL and PCNL groups at 1-month follow-up, although PCNL was superior to FURL after immediately post-surgery. FURL exhibited significantly fewer complications overall (5.7% vs. 19.3%, p = 0.044), shorter hospital stays, and lower postoperative pain levels. The surgical parameters favored FURL, showing lower bleeding volumes, shorter catheter removal times, and less hemoglobin decrease postoperatively.

Conclusion: Despite similar stone clearance efficacy at 1-month follow-up, FURL demonstrated superior safety and postoperative outcomes compared to PCNL for 2-3 cm renal calculi. These findings highlight the potential advantages of FURL in reducing complications, enhancing recovery, and optimizing patient care pathways.