| Objective To observe the therapeutic effect of flexible ureteroscope lithotripsy(FURL) combined with a flexible vacuum suction ureteral access sheath(FV-UAS) in the treatment of 2～2.5 cm lower calyceal calculi. Methods A retrospective study was conducted on 98 patients with lower calyceal calculi who underwent surgical treatment in Wuhan Kyoto Stone Urology Hospital from August 2024 to August 2025. The patients were divided into a FURL group(47 cases) and a combined group(51 cases) based on the surgical methods. Patients in the FURL group were treated with FURL, while those in the combined group were treated with FURL combined with FV-UAS. The surgical indicators, postoperative stone clearance rates, inflammatory response levels, preoperative and postoperative renal function, hematuria, and complication rates were compared between the two groups. Results The combined group had shorter operative time and less intraoperative blood loss than the FURL group(P < 0.05). At 1 day and 4 weeks after the operation, the combined group had a higher stone clearance rate than the FURL group(P<0.05). After the operation, the combined group had lower levels of serum C-reactive protein(CRP), procalcitonin(PCT), white blood cell count(WBC), serum creatinine(Scr), and the number of red blood cells in urine than the FURL group(P<0.05). The total incidence of postoperative complications in the combined group was lower than that in the FURL group(P<0.05). Conclusion The combined use of FURL and FV-UAS for treating lower calyceal stones ranging from 2 to 2.5 cm in size can shorten the operative time, increase the stone clearance rate, reduce postoperative inflammatory reactions and renal damage, and lower the risk of complications, making a safe and efficient surgical approach. |
