title: Transperitoneal versus retroperitoneal laparoscopic ureterolithotomy: a prospective randomized comparison study.
abstract: OBJECTIVE
  We compared laparoscopic transperitoneal and retroperitoneal ureterolithotomy approaches, and determined whether one technique is superior to the other.
  
  
  METHODS
  In this prospective randomized study from January 2009 to May 2012, 48 patients with proximal or mid ureteral stones underwent transperitoneal laparoscopic ureterolithotomy or retroperitoneal laparoscopic ureterolithotomy. The randomization occurred on a 1:1 basis. Groups 1 and 2 consisted of patients who underwent transperitoneal laparoscopic ureterolithotomy and retroperitoneal laparoscopic ureterolithotomy, respectively. Demographic and clinical characteristics as well as postoperative data were collected and analyzed. Statistical analysis was performed with SPSS® version 15.0 using the Fisher exact and Mann-Whitney U tests with p <0.05 considered statistically significant.
  
  
  RESULTS
  The difference in visual pain analog score and mean tramadol requirement on days 1 and 2 between the 2 groups was statistically significant, and was higher in group 1 (p <0.05). Postoperative hospital stay and paralytic ileus rates were significantly higher in group 1 (p <0.05). The differences in total operative time and intracorporeal suturing time between the 2 groups were not statistically significant. However, successful stone removal was equal in the 2 groups.
  
  
  CONCLUSIONS
  For proximal or mid ureteral large and impacted stones, transperitoneal laparoscopic ureterolithotomy is significantly associated with pain, greater tramadol requirement, ileus and longer hospital stay than retroperitoneal laparoscopic ureterolithotomy. However, successful stone removal remains the same in both groups.
authors.affiliation: Department of Urology and the Department of Psychiatry (AA), C.S.M. Medical University (Upgraded King George Medical College), Lucknow, Uttar Pradesh, India. vishwajeeturo@sify.com
authors.forename: Vishwajeet
authors.initials: V
authors.lastname: Singh
authors.forename: Rahul Janak
authors.initials: RJ
authors.lastname: Sinha
authors.forename: Dheeraj Kumar
authors.initials: DK
authors.lastname: Gupta
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.forename: Asif
authors.initials: A
authors.lastname: Akhtar
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D010537:Peritoneum / Q000601:surgery*; D011446:Prospective Studies; D012187:Retroperitoneal Space / Q000601:surgery*; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014514:Ureteral Calculi / Q000601:surgery*