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    Korean J Urol. 2009 Apr;50(4):349-354. Korean.
    Published online Apr 27, 2009.
    https://doi.org/10.4111/kju.2009.50.4.349
    Copyright © The Korean Urological Association, 2009
    Original Article

    The Outcome of Laparoscopic Retroperitoneal Ureterolithotomy for the Management of Upper Ureteral Stones Larger than 10 mm: A Comparison with Rigid Ureteroscopic Removal of Stones with Lithoclast®

    Woo Jin Park, Jun O Kwon and Tae Hee Oh
      • Department of Urology, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.
    • Correspondence to: Tae Hee Oh. Department of Urology, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, 50, Hapseong 2-dong, Masan 630-723, Korea. TEL: 055-290-6057, FAX: 055-290-6059, Email: natisururo@yahoo.co.kr
    Received December 24, 2008; Accepted February 11, 2009.

    Abstract

    Purpose

    We evaluated the outcome of laparoscopic retroperitoneal ureterolithotomy (LRU) and compared the results with the rigid ureteroscopic removal of stones with the Lithoclast® (rigid URS) for the management of large upper ureteral stones (≥10 mm).

    Materials and Methods

    Between July 2002 and March 2008, rigid URS and LRU were performed in 37 and 24 patients, respectively. We evaluated the outcomes of each procedure and compared the success rate according to the location (above and below the L3 level by the third intervertebral disc of the lumbar spine) and size of the stones (10-15 mm and ≥15 mm in diameter).

    Results

    The overall success rate for rigid URS and LRU were 70.3% (26/37) and 91.7% (22/24), respectively (p=0.059). For rigid URS, the success rate was 50.0% (8/16) and 85.7% (18/21) for stones above and below the L3 level (p=0.030), respectively, and 85.7% (23/28) and 33.3% (3/9) for stones 10-15 mm and ≥15 mm in diameter, respectively (p=0.011). For LRU, the success rate was 92.3% (12/13) and 90.9% (10/11) for stones above and below the L3 level, respectively (p=0.902), and 50.0% (1/2) and 95.5% (21/22) for stones 10-15 mm and ≥15 mm in diameter, respectively.

    Conclusions

    LRU demonstrated a high success rate regardless of the location and size of the stones. The outcomes with rigid URS were more varied. These results suggest that LRU is a feasible alternative for large upper ureteral stones that are 15 mm or more in size or located above the intervertebral disc between the third and fourth lumbar vertebrae.

    Keywords
    Ureteral calculi; Ureteroscopy; Laparoscopy; Lithotripsy

    Tables

    Table 1
    The success rate according to the location and size of the stones after rigid ureteroscopic removal of stones with Lithoclast® or laparoscopic retroperitoneal ureterolithotomy for upper ureteral stones

    Table 2
    Results of successful laparoscopic retroperitoneal ureterolithotomy

    References

      1. Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gallucci M. Guidelines on urolithiasis. Eur Urol 2001;40:362–371.
      1. Segura JW, Preminger GM, Assimos DG, Dretler SP, Khan RI, Lingeman JE, et al. Ureteral stones clinical guidelines panel summary report on the management of ureteral calculi. The American Urological Association. J Urol 1997;158:1915–1921.
      1. Kijvikai K, Haleblian GE, Preminger GM, de la Rosette J. Shock wave lithotripsy or ureteroscopy for the management of proximal ureteral calculi: an old discussion revisited. J Urol 2007;178:1157–1163.
      1. Netto Junior NR, Claro JF, Lemos GC, Cortado PL. Treatment options for ureteral calculi: endourology or extracorporeal shock wave lithotripsy. J Urol 1991;146:5–7.
      1. Higashihara E, Horie S, Takeuchi T, Kameyama S, Asakage Y, Hosaka Y, et al. Laser ureterolithotripsy with combined rigid and flexible ureteroscopy. J Urol 1990;143:273–274.
      1. Dretler SP. An evaluation of ureteral laser lithotripsy: 225 consecutive patients. J Urol 1990;143:267–272.
      1. Paik ML, Wainstein MA, Spirnak JP, Hampel N, Resnick MI. Current indications for open stone surgery in the treatment of renal and ureteral calculi. J Urol 1998;159:374–379.
      1. Bichler KH, Lahme S, Strohmaier WL. Indications for open stone removal of urinary calculi. Urol Int 1997;59:102–108.
      1. Lee YK, Park DS, Hong YK. Ureteroscopic lithotripsy with pneumatic lithotriptor: 274 cases. Korean J Urol 2006;47:625–630.
      1. Sun YB, Heo DS, Woo JH, Kim YH, Park HJ, Kwon CH. 376 cases of ureteroscopic stone removal. Korean J Urol 1999;40:546–550.
      1. Wolf JS Jr. Treatment selection and outcomes: ureteral calculi. Urol Clin North Am 2007;34:421–430.
      1. Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck C, Gallucci M, et al. 2007 guideline for the management of ureteral calculi. J Urol 2007;178:2418–2434.
      1. Lyon ES, Kyker JS, Schoenberg HW. Transurethral ureteroscopy in women: a ready addition to the urological armamentarium. J Urol 1978;119:35–36.
      1. Perez-Castro Ellendt E, Martinez-Pineiro JA. Transurethral ureteroscopy. A current urological procedure. Arch Esp Urol 1980;33:445–460.
      1. Chung HS, Park JY, Kim HK, Park CM. Efficacy of the stone cone for treatment of proximal ureteral stones: an initial clinical experience. Korean J Urol 2006;47:412–417.
      1. Sozen S, Kupeli B, Tunc L, Senocak C, Alkibay T, Karaoglan U, et al. Management of ureteral stones with pneumatic lithotripsy: report of 500 patients. J Endourol 2003;17:721–724.
      1. Aghamir SK, Mohseni MG, Ardestani A. Treatment of ureteral calculi with ballistic lithotripsy. J Endourol 2003;17:887–890.
      1. Aridogan IA, Zeren S, Bayazit Y, Soyupak B, Doran S. Complications of pneumatic ureterolithotripsy in the early postoperative period. J Endourol 2005;19:50–53.
      1. Chung HS, Kim HK, Park CM. The varying success of ureteroscopic removal of stone (URS) in relation to the different locations and sizes of upper ureter stones. Korean J Urol 2005;46:920–924.
      1. Raboy A, Ferzli GS, Ioffreda R, Albert PS. Laparoscopic ureterolithotomy. Urology 1992;39:223–225.
      1. Gaur DD. Laparoscopic operative retroperitoneoscopy: use of a new device. J Urol 1992;148:1137–1139.
      1. Skrepetis K, Doumas K, Siafakas I, Lykourinas M. Laparoscopic versus open ureterolithotomy. A comparative study. Eur Urol 2001;40:32–36.
      1. Flasko T, Holman E, Kovacs G, Tallai B, Toth C, Salah MA. Laparoscopic ureterolithotomy: the method of choice in selected cases. J Laparoendosc Adv Surg Tech A 2005;15:149–152.
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    MeSH Terms
    Humans
    Intervertebral Disc
    Laparoscopy
    Lithotripsy
    Lumbar Vertebrae
    Ureter
    Ureteral Calculi
    Ureteroscopy
    Metrics
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