title: Nephrolithotomy performed concurrently with laparoendoscopic single-site pyeloplasty.
abstract: BACKGROUND
  The objective of the present study was to evaluate the results of laparoendoscopic single-site (LESS) pyeloplasty and pyelolithotomy, which were performed concurrently in patients with pelviureteric junction obstruction (PUJO) and renal stones.
  
  
  METHODS
  Four patients with PUJO and renal stones underwent pyelolithotomy performed concurrently with LESS pyeloplasty. In 3 patients, a 2.5-cm incision was made in the umbilical region. In the fourth patient, the 2.5-cm vertical incision was made at a site 7 cm below the umbilical region because of a stone in the right lower calyx. After dissection of the pelviureteric junction, an incision of approximately 1 cm was made along the presumed transection line of the renal pelvis. The pyelolithotomy was performed using a 24F rigid nephroscope through a SILS port. Dismembered pyeloplasty was performed after extraction of the renal stones was completed. The mean operation time was 277 minutes (range, 225-373), and the mean lithotomy time was 31 minutes (range, 20-50). No intraoperative or postoperative complications were observed. For all 4 patients, discharge from the hospital was possible after a mean of 3.4 postoperative days (range, 3-4). All patients became stone free. Postoperative ultrasound revealed that hydronephrosis improved in all patients. In all patients, resolution of the symptoms was confirmed.
  
  
  CONCLUSIONS
  LESS nephrolithotomy with pyeloplasty is a safe and effective procedure with a good cosmetic result for patients with PUJO and renal stones.
authors.affiliation: Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Naitoh
authors.affiliation: Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Urology, Shiga University of Medical Science, Shiga, Japan. Electronic address: kawauchi@koto.kpu-m.ac.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawauchi
authors.affiliation: Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kamoi
authors.affiliation: Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Jintetsu
authors.initials: J
authors.lastname: Soh
authors.affiliation: Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Fumiya
authors.initials: F
authors.lastname: Hongo
authors.affiliation: Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Okihara
authors.affiliation: Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Miki
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000601:surgery*; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D014517:Ureteral Obstruction / Q000150:complications / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D055815:Young Adult