Laparoscopic surgery for lumbar ureteric stones

Tania González León; M Elena Suárez Marcillán; Yaimara Cuza Herrera; Alemayehu Tegegne; Yumar de la Paz Pérez; Lisset Rodríguez-Ojea

2016, Number 1

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RCU 2016; 5 (1)

Laparoscopic surgery for lumbar ureteric stones

Gonzalez LT, Suárez MME, Cuza HY, Tegegne A, de la Paz PY, Rodríguez-Ojea L

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ABSTRACT

Introduction: Laparoscopic surgery has gradually replaced open surgery. Nowadays, it is used to remove ureteral and renal stones. Laparoscopic ureterolithotomy (LUL) is considered relatively easy and has been used in both transperitoneal and retroperitoneal approaches. This work group has considered the retroperitoneal approach because of its advantages.
Materials and Methods: A prospective and descriptive study was carried out in The Urology Deparment at the National Center for Minimally Invasive Surgery (NCMIS) between 2011 and 2013, in a series of 57 patients with lithiasis located in the lumbar ureter, ≥ 1 cm, impacted, or with failed extracorporeal lithotripsy treatment or ureteroscopy. A retroperitoneal approach was performed, three trocars and 0° optic were used, and monopolar cutting for the ureteral incision and ureteral JJ catheter.
Results: Male sex prevailed and average age was 46, 5 years. Lithiasis was localized in the upper lumbar ureter in most and 71, 92% were › 1,5 cm. Operative time was 96,4 minutes. Blood loss was minimal. Hospital stay was 2,6 days. LUL was 100% feasible and 98,2% were free from lithiasis (resolution). There were no transoperative complications. There were 15,7% postoperative complications and 8,7% were due to urinary infection. Two patients had grade III complications.
Conclusions: LUL is a feasible and successful alternative for large and impacted lithiasis in the lumbar ureter, with high resolution and low morbidity.

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