Percutaneous Nephrolithotomy Versus Open Surgery in the Treatment of Urinary Calculi.

OBJECTIVE: To evaluate the effectiveness of percutaneous nephrolithotomy (PCNL) compared with open surgery for urinary stone removal.

METHODS: A total of 95 patients with urinary stones were screened for eligibility between October 2020 and December 2021. After excluding 5 patients who revoked their consent, 90 patients were randomized to receive either traditional open surgery (traditional group) or PCNL (PCNL group), with 45 patients in each group. In addition, the two groups received Shugan Qingre Tonglin decoction twice daily for 2 weeks. Outcome measures included intraoperative indexes, stone removal rate, postoperative healing, and quality of life.

RESULTS: PCNL resulted in significantly better intraoperative indexes (95% CI, 0.49-1.11; P < .001), lower creatinine concentration (95% CI, 0.59-1.61; P < .001), and higher glomerular filtration rate (95% CI, 2.43-2.91; P < .001) compared with traditional open surgery. Patients in the PCNL group had a significantly higher stone removal rate (95% CI, 1.09-2.51; P < .001) and a lower incidence of adverse events (95% CI, 0.69-1.87; P < .001) compared with those receiving traditional open surgery. Patients in the PCNL group had significantly higher quality of life (95% CI, 1.39-2.81; P < .001) and significantly higher maximum urinary flow rate (95% CI, 1.36-2.61; P < .001) than those in the traditional group at 1 month and 3 months after treatment.

CONCLUSION: PCNL provides better postoperative renal function improvement, enhances the postoperative recovery of patients with urinary stones, and features manageable safety compared with traditional open surgery. The benefits of PCNL make it a promising technique for the clinical management of urinary stones. Its minimally invasive nature reduces patient discomfort, promotes faster recovery, and improves overall patient satisfaction. The superior outcomes of PCNL in terms of renal function improvement and postoperative recovery suggest that it is a viable alternative to traditional open surgery. Further research and clinical trials are warranted to validate these findings and establish PCNL as a widely adopted approach in the field of urology.