Experience and learning curve of retroperitoneal laparoscopic ureterolithotomy for upper ureteral calculi.
OBJECTIVE
To summarize our experience and evaluate the learning curve of retroperitoneal laparoscopic ureterolithotomy of the upper ureter.


METHODS
Between May 2004 and May 2007, 40 patients underwent retroperitoneal laparoscopic ureterolithotomy of the upper ureter. We divided the first and last 20 patients into group I and group II. There was no statistical difference in stone size between groups. Operative time and complications were measured as a basis for the assessment of the learning curve.


RESULTS
In group I, the complication rate was 15% (3/20), including two patients whose procedure was converted to open surgery because of intraoperative bleeding, and one patient who experienced urine leakage because of a displaced Double-J ureteral stent. In group II, no postoperative complications occurred, while the mean operative time was significantly shorter compared with the earlier operations (65 vs 120 min).


CONCLUSIONS
Retroperitoneal laparoscopic ureterolithotomy is safe and effective for large or impacted stones of the upper ureter. It is associated with a short learning curve in the setting of an active laparoscopic practice for selected patients.
Fan
Tianyong
T
Department of Urology, West China Hospital, Sichuan University, Chengdu, China. fantianyong@hotmail.com
Xian
Peng
P
Yang
Lu
L
Liu
Yong
Y
Wei
Qiang
Q
Li
Hong
H
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007858:Learning; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space / Q000601:surgery*; D013997:Time Factors; D014514:Ureteral Calculi / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000193:education*; D055815:Young Adult