Our Experiences of Transperitoneal and Retroperitoneal Laparoscopic Ureterolithotomy in the Treatment of Ureteral Stone

Abstract

INTRODUCTION: In this study, we performed our experience of retroperitoneal and transperitoneal laparoscopic ureterolithotomy in the treatment of proximal ureteral stones and evaluated these two methods comparatively. METHODS: The data of 41 patients who underwent laparoscopy for upper or middle ureteral stones were analyzed. The stone size of the patients who underwent laparoscopic ureterolithotomy was more than 15 mm, unilateral, impacted and upper of the sacroiliac junction. Gender, age, side and size of ureteral stones, operation time, blood loss, duration of hospital stay and complications were evaluated in all patients. RESULTS: The mean duration of operation was 119,5+-2,12 in the laparoscopic retroperitoneal group and 105,5+-4,94 in the transperitoneal laparoscopic ureterolithotomy group. Compared with the operation techniques, operation time is statistically shorter in transperitoneal group than retroperitoneal group(p <0.05). When we compared the periods of return to daily activities after operation, laparoscopic retroperitoneal group was found to be significantly shorter. Stoneless rates were similar in both groups. DISCUSSION AND CONCLUSION: In less experienced centres, the transperitoneal method is more advantageous than the retroperitoneal method because of its wider operative area, regular anatomy, and ease of suturing. In the retroperitoneal approach, short hospital stay, early drainage, and ureteral catheter withdrawal are avantages. The experience of the surgeon in selecting the laparoscopic method is important.

Keywords

• laparoscopic ureterolithotomy
• ureteral stone
• ureterolithotomy
• proximal ureteral stones