Retroperitoneal laparoscopic ureterolithotomy for upper ureter stones.
We evaluated the role of retroperitoneal laparoscopic ureterolithotomy (RPLU) for upper ureter stones. Between February 1998 and July 2004, 12 patients (10 men and 2 women) underwent RPLU for upper ureter stones (mean size 18.1 mm, range 10-25). RPLU was carried out in 5 patients as a salvage treatment after failed shock wave lithotripsy (SWL) (3) and both of failed SWL and ureteroscopy (URS) (2), and in 7 patients as primary treatment for large impacted stones. Total 6 of 12 cases were converted to open surgery. The reason of open conversion was failure of locating ureter due to severe adhesion in 5 cases and vascular injury in 1 case. In 6 successful cases, mean operation time, mean estimated blood loss, and mean postoperative hospital stay were respectively 109 min (90-120 min), 50 mL (10-100 mL), 4.6 days (2-7 days). There was no serious postoperative complication except for one patient who showed delayed urinary leakage but was cured with conservative management. Our experience suggested that RPLU was not easy to perform simply because it was indicated mainly in ureter stones with severe adhesion or after failed SWL and/or URS. Nevertheless, it can be considered as a primary procedure before open ureterolithotomy.
Jeong
Byong Chang
BC
Department of Urology, Seoul National University Boramae Hospital, Korea.
Park
Hyeung Keun
HK
Byeon
Seok Soo
SS
Kim
Hyeon Hoe
HH
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D012187:Retroperitoneal Space / Q000473:pathology; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014513:Ureter / Q000473:pathology; D014514:Ureteral Calculi / Q000628:therapy*; D013520:Urologic Surgical Procedures / Q000379:methods*