微创经皮肾盂镜( mPNL )和经肾内镜手术（ RIRS ）是治疗肾结石的两种主要内镜管理策略。本研究旨在比较mPNL和RIRS治疗伴有回肠引流的10-20mm肾结石的疗效和安全性。回顾性选取了2015年1月至2022年6月间经历mPNL或RIRS治疗大小为10-20mm单侧肾结石的有膀胱癌和回肠引流病史的患者，并分析比较了基线特征和围手术期结果。首次手术失败率对于mPNL和RIRS分别为2.5%和18.9%（P=0.025）。最终纳入39名患者和30名患者分别在mPNL组和RIRS组。mPNL组的单次无结石率（SFR）高于RIRS组（97.4% vs. 66.7%，P=0.002）。然而，在手术时间、术后住院时间、Clavien-Dindo分类下并发症，以及手术前后血红蛋白、肌酐、降钙素原和疼痛视觉模拟量表评分的变化方面，两组之间没有统计学意义上的差异。此外，在年份分层分析中的结果在2015-2018年和2019-2022年的患者中持续一致。mPNL和RIRS均可用于治疗有回肠引流的10-20mm肾结石，但mPNL在较高的SFR结果下具有类似并发症发生率，因此对于特定患者可能是可行的选择。

Both mini-percutaneous nephrolithotomy (mPNL) and retrograde intrarenal surgery (RIRS) are two major strategies for the endourological management of kidney stones. In the current study, we aimed to compare the efficacy and safety of mPNL and RIRS for the treatment of 10-20 mm kidney stones in patients with ileal conduit.Patients with a history of bladder cancer and ileal conduit who had undergone mPNL or RIRS for unilateral kidney stones 10-20 mm in size between January 2015 and June 2022 were retrospectively included. Baseline characteristics and perioperative outcomes were analyzed and compared between mPNL and RIRS.The failure rate of the initial surgery was 2.5% and 18.9% for mPNL and RIRS, respectively (P=0.025). In total, 39 and 30 patients were finally included in the mPNL and RIRS groups. One-session stone-free rate (SFR) was higher in the mPNL group than the RIRS group (97.4% vs. 66.7%, P=0.002). However, there was no statistically significant difference between the two groups with regard to operation time, postoperative hospitalization, complications according to Clavien-Dindo classification, as well as the change in hemoglobin, creatinine, procalcitonin, and pain Visual Analogue Scale Score before and after the surgery. Moreover, Results were consistent across subgroup analyses in patients stratified by years (2015-2018 and 2019-2022).Both mPNL and RIRS were feasible and safe for the treatment of 10-20 mm kidney stones in patients with ileal conduit. However, mPNL achieved superior SFR outcomes with a similar incidence of complications, and it might be a sensible alternative for selected patients.