Abstract: Objective To study the effect of flexible ureteroscopic lithotripsy(FURSL)and miniaturized percutaneous nephrolithotomy(MPCNL)on lower-calyx calculi in elderly patients and their effects on PCT,CRP and IL-6 levels in patients with lower-calyx calculi.
Methods A total of 102 patients who underwent FURSL(n=50) or MPCNL(n=52) for subrenal calyx calculus stones from January 2018 to December 2020 were retrospectively analyzed.the Intraoperative and postoperative data including stone-free rate and complications were compared,the levels of serum PCT,CRP and IL-6 were detected before and 24 h after operation.
Results The one-time stone removal rate and operation time of FURSL group[70.00%,(46.83±4.09)min] were lower than those of MPCNL group[88.46%,(35.47±6.33)min](P<0.05).Compared with MPCNL group,the incidence of delayed bleeding and the decrease of hemoglobin in FURSL group[0,(2.72±0.65)g/L] were better than MPCNL Group[13.46%,(3.18±0.74)g/L] with significant difference(P<0.05).The serum levels of PCT,CRP and IL-6 were (0.11±0.04)ng/ ml,(10.50±2.64)mg/L,(12.12±3.23)pg/ml and (0.07±0.02)ng/ml,(12.38±1.91)mg/L,(11.32±3.23)pg/ml at 24h and 72h after MPCNL,respectively,and those in FURSL group were (0.09±0.03)ng/ml,(9.46±2.53)mg/L,(10.01±2.74)pg/ml and (0.06±0.01)ng/ml,(11.22 ±1.74)mg/L,(9.28±2.53)pg/ml,respectively.MPCNL group was higher than FURSL group(all P<0.05).
Conclusion FURSL and MPCNL are both effective and safe for treating subrenal calyx caculus with a diameter of 2～3cm.MPCNL shows more higher stone free rate.However,FURSL is associated with less reauma,less bleeding and mild inflammatory reaction.

Key words: flexible ureteroscopic lithotripsy, subrennal calyx caculus, miniaturized percutaneous nephrolithotomy