title: A comparison of antegrade percutaneous and laparoscopic approaches in the treatment of proximal ureteral stones.
abstract: OBJECTIVE
  To compare the effectiveness and safety of retroperitoneal laparoscopic ureterolithotomy (RLU) and percutaneous antegrade ureteroscopy (PAU) in which we use semirigid ureteroscopy in the treatment of proximal ureteral stones.
  
  
  METHODS
  Fifty-eight patients with large, impacted stones who had a history of failed shock wave lithotripsy (SWL) and, retrograde ureterorenoscopy (URS) were included in the study between April 2007 and April 2014. Thirty-seven PAU and twenty-one RLU procedures were applied. Stone-free rates, operation times, duration of hospital stay, and follow-up duration were analyzed.
  
  
  RESULTS
  Overall stone-free rate was 100% for both groups. There was no significant difference between both groups with respect to postoperative duration of hospital stay and urinary leakage of more than 2 days. PAU group had a greater amount of blood loss (mean hemoglobin drops for PAU group and RLU group were 1.6±1.1 g/dL versus 0.5±0.3 g/dL, resp.; P=0.022). RLU group had longer operation time (for PAU group and RLU group 80.1±44.6 min versus 102.1±45.5 min, resp.; P=0.039).
  
  
  CONCLUSIONS
  Both PAU and RLU appear to be comparable in the treatment of proximal ureteral stones when the history is notable for a failed retrograde approach or SWL. The decision should be based on surgical expertise and availability of surgical equipment.
authors.affiliation: Urology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, 06310 Ankara, Turkey.
authors.forename: Hikmet
authors.identifier: 0000-0001-7731-5017
authors.initials: H
authors.lastname: Topaloglu
authors.affiliation: Urology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, 06310 Ankara, Turkey.
authors.forename: Nihat
authors.identifier: 0000-0002-6680-9860
authors.initials: N
authors.lastname: Karakoyunlu
authors.affiliation: Urology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, 06310 Ankara, Turkey.
authors.forename: Sercan
authors.initials: S
authors.lastname: Sari
authors.affiliation: Urology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, 06310 Ankara, Turkey.
authors.forename: Hakki Ugur
authors.initials: HU
authors.lastname: Ozok
authors.affiliation: Urology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, 06310 Ankara, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Sagnak
authors.affiliation: Department of Urology, Hitit University Faculty of Medicine, 19030 Corum, Turkey.
authors.forename: Hamit
authors.initials: H
authors.lastname: Ersoy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D014514:Ureteral Calculi / Q000473:pathology / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*