title: Transperitoneal mini-laparoscopic pyeloplasty and concomitant ureteroscopy-assisted pyelolithotomy for ureteropelvic junction obstruction complicated by renal caliceal stones.
abstract: OBJECTIVE
  To present our experience of combining transperitoneal mini-laparoscopic pyeloplasty (mini-LP) and concomitant ureteroscopy-assisted pyelolithotomy (U-P) for ureteropelvic junction obstruction (UPJO) complicated by renal caliceal stones in the same session.
  
  
  METHODS
  Between May 2007 and December 2011, mini-LP and concomitant U-P was performed in nine patients with UPJO and ipsilateral renal caliceal stones. Stone location and burden were preoperatively assessed. After pyelotomy with appropriate length (about 4 mm), a 16-Fr catheter sheath replaced the uppermost or lowermost laparoscopic trocar and was introduced directly into the renal pelvis under the guidance of a guide wire and laparoscopic vision. A 7.5F rigid ureteroscopy passed through the catheter sheath into the plevis. Intracorporeal lithotripsy and/or pressure irrigation via a pump was used for caliceal stone removal. Subsequently, laparoscopic pyeloplasty was performed in a standard fashion. Postoperative imaging was assessed.
  
  
  RESULTS
  The calculi sizes ranged from 2 to 11 mm (mean, 7.1 mm) and an average of 3 stones per patient was removed (range, 1 to 6 stones). Complete stone clearance confirmed by postoperative imaging was achieved in all patients. Mean operative time was 210 minutes, and estimated blood loss was 20 mL. Mean hospital stay was 5 days (4-7). Stent was removed after 4-8 weeks. No intraoperative or postoperative complications were noted during a mean follow-up of 18.5 months (range, 6 to 24 months).
  
  
  CONCLUSIONS
  Mini-LP and concomitant U-P are simple and effective alternatives for the simultaneous management of UPJO complicated by coexisting ipsilateral renal caliceal stones.
authors: Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors: Zhi
authors: Z
authors: Chen
authors: Peng
authors: P
authors: Zhou
authors: Zhong-Qing
authors: ZQ
authors: Yang
authors: Yang
authors: Y
authors: Li
authors: Yan-Cheng
authors: YC
authors: Luo
authors: Yao
authors: Y
authors: He
authors: Nan-Nan
authors: NN
authors: Li
authors: Chao-Qun
authors: CQ
authors: Xie
authors: Chen
authors: C
authors: Lai
authors: Xiao-Long
authors: XL
authors: Fang
authors: Xiang
authors: X
authors: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D057785:Catheters; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D018666:Ureteroscopy; D055815:Young Adult