Evaluation of Efficiency and Safety of Transperitoneal Laparoscopic Ureterolithotomy for Treatment of Lumbar Ureteric Stones
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- Category: Vol. 85, June 2017
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Evaluation of Efficiency and Safety of Transperitoneal Laparoscopic Ureterolithotomy for Treatment of Lumbar Ureteric Stones, MOHAMED FAWZY, HUSSEIN HOSNY, SAYED ELEWEEDY, MOHAMED ABD EL-KHALEK, ABD EL-BASET EL-EMAM, AYMAN GABR, SHERIF SWAR, ALAA EL-SHENNAWY, AHMED SEDIK and AHMED MOSTAFA
Abstract
Objective: To evaluate the efficacy and safety of transperi-toneal laparoscopic ureterolithotomy for treatment of lumbar ureteric stones.
Patients and Methods: A prospective clinical study was conducted on 20 patients with a single upper ureteric stone with size >1cm. The patients were selected at two urological centers: Al-Azhar University Hospitals and the National Institute of Urology and Nephrology (NIUN) and they were treated by transperitoneal laparoscopic ureterolithotomy. All patients were evaluated peri-operatively and followed-up 3 months post-operatively. Patients with recurrent stone, stricture ureter below the stone, previous intraperitoneal surgery, coagulopathy, urinary tract anomalies, active UTI or pregnancy were excluded from the study.
Results: Stone size: Ranges from 1.0 to 2.1cm with mean size of 1.57±0.32cm, operative time: Showed a mean of 80.3± 27.1, all patients in both centers had a non-significant blood loss that was <50cc, stenting: Al-Azhar group were non-stented while NIUN group were stented, drain output: Showed mean of 461.1±340.3cc, hospital stay: Showed mean of 4.2± 3.1 day.
Complications: 2 patients in Al-Azhar group had persistent urinary leakage that was managed by DJ fixation, post-operative pain level: By numerical rating pain scale was 2/10, hemoglobin drop: Showed mean of 0.43±0.22mg/dl.
Follow-up 3 months post-operative: Pelvi-abdominal ultrasound showed improvement in the renal backpressure in 13 patients (65%) and total resolve in 7 patients (35%), all patients showed great acceptance and appreciation as regard the cosmetic outcome and the small healed incisions.
Conclusion: Transperitoneal laparoscopic lumbar uretero-lithotomy is an efficient safe management modality for treat-ment of lumbar ureteric stones with its high stone free rate, low morbidity rate, less postoperative pain, short hospital stay and good cosmetic results.