title: Comparative study on ureteroscopic lithotripsy and laparoscopic ureterolithotomy for treatment of unilateral upper ureteral stones.
abstract: OBJECTIVE
  To compare the curative effects of ureteroscopic lithotripsy and laparoscopic ureterolithotomy for unilateral upper ureteral stones, and to explore optimal surgical indications and skills.
  
  
  METHODS
  Fifty cases of unilateral upper ureteral stones were randomly divided into two groups: one group underwent ureteroscopic holmium laser lithotripsy under epidural or lumbar anesthesia (n=25), and another group underwent laparoscopic ureterolithotomy under general anesthesia (n=25). Double-J stent was routinely indwelled in both groups. Operating time, postoperative hospitalization time, stone clearance rate and perioperative complications were compared.
  
  
  RESULTS
  Operation was successfully performed in all 50 cases, and no open surgery was converted in any case. In the ureteroscopy and laparoscopy groups, the mean operating time was 49.0 ± 10.7 min and 41.8 ± 8.0 min (t=2.68, P=0.00999), respectively, their hospitalization time was 2.8 ± 1.3 days vs. 2.9 ± 0.8 days (t =-0.40, P=0.69413), and stone clearance rate was 88.0% (22/25) vs. 100% (25/25). Stone moved to the renal pelvis in three cases in the ureteroscopy group, and residual stones were removed by extracorporeal shock-wave lithotripsy (ESWL). All patients were followed up for more than three months, and no serious complications such as ureterostenosis occurred.
  
  
  CONCLUSIONS
  Laparoscopic ureterolithotomy has a higher stone clearance rate and shorter operation time compared with ureteroscopic lithotripsy. Laparoscopic ureterolithotomy is one safe and effective treatment on unilateral upper ureteral stones.
authors.affiliation: Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, China.
authors.forename: You-qiang
authors.initials: YQ
authors.lastname: Fang
authors.forename: Jian-guang
authors.initials: JG
authors.lastname: Qiu
authors.forename: De-juan
authors.initials: DJ
authors.lastname: Wang
authors.forename: Hai-lun
authors.initials: HL
authors.lastname: Zhan
authors.forename: Jie
authors.initials: J
authors.lastname: Situ
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D017602:Lithotripsy, Laser / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*; D018666:Ureteroscopy / Q000009:adverse effects / Q000379:methods*