Evaluation of the role of preoperative Double-J ureteral stenting in retroperitoneal laparoscopic pyelolithotomy.
BACKGROUND
Since the first retroperitoneal laparoscopic pyelolithotomy (RPPL) was reported by Gaur and associates in 1994, its technique has improved considerably. The applicability and indications of the procedure are expanding with advances in technology, expertise, and experience. To date, there has been no prospective study in the literature about the role of preoperative Double-J (D-J) ureteral stenting in patients who undergo RPPL. This study is an endeavor to evaluate the role of preoperative D-J stenting in RPPL.


METHODS
The study included 184 patients, who were randomized into 2 groups. Group A included 95 patients, who underwent RPPL with D-J stenting. Group B included 89 patients, who underwent RPPL without D-J stenting. In group A, D-J stents were inserted under local anesthesia preoperatively, on the side of surgery. Complications during surgery and during the postoperative period were carefully recorded.


RESULTS
The duration of drainage and volume in group A was significantly lower than in group B. The duration of postoperative stay was significantly reduced in group A (mean 3.3 vs. 5.74 days). The analgesic requirement in group A also was significantly lower than in group B (mean 378.95 vs. 558.99 mg). No statistically significant difference existed between the two groups, in terms of minor intraoperative and postoperative complications (25.3% vs. 29.2%; p < or = 0.547).


CONCLUSIONS
D-J stenting and type of renal pelvis influenced the results, i.e., duration of drainage, analgesic requirement, and duration of stay, in patients undergoing RPPL. However, there was no significant difference in operative time, intraoperative blood loss, and postoperative complications. D-J stent group had significant increase in the rate of urinary tract infection postoperatively.
Chander
Jagdish
J
Department of Surgery, Maulana Azad Medical College, Delhi, India. drjchander@hotmail.com
Dangi
Anuj Deep
AD
Gupta
Nikhil
N
Vindal
Anubhav
A
Lal
Pawanindra
P
Ramteke
V K
VK
D000293:Adolescent; D000328:Adult; D000368:Aged; D004322:Drainage; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D007682:Kidney Pelvis / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D019919:Prosthesis Implantation / Q000009:adverse effects*; D012187:Retroperitoneal Space; D015607:Stents / Q000009:adverse effects*; D014513:Ureter / Q000601:surgery; D055815:Young Adult