J Korean Med Sci.  2006 Jun;21(3):441-444. 10.3346/jkms.2006.21.3.441.

Retroperitoneal Laparoscopic Ureterolithotomy for Upper Ureter Stones

• Jeong BC
• Park HK
• Byeon SS
• Kim HH

• KMID: 1778425
• DOI: http://doi.org/10.3346/jkms.2006.21.3.441

Abstract

We evaluated the role of retroperitoneal laparoscopic ureterolithotomy (RPLU) for upper ureter stones. Between February 1998 and July 2004, 12 patients (10 men and 2 women) underwent RPLU for upper ureter stones (mean size 18.1 mm, range 10-25). RPLU was carried out in 5 patients as a salvage treatment after failed shock wave lithotripsy (SWL) (3) and both of failed SWL and ureteroscopy (URS) (2), and in 7 patients as primary treatment for large impacted stones. Total 6 of 12 cases were converted to open surgery. The reason of open conversion was failure of locating ureter due to severe adhesion in 5 cases and vascular injury in 1 case. In 6 successful cases, mean operation time, mean estimated blood loss, and mean postoperative hospital stay were respectively 109 min (90-120 min), 50 mL (10-100 mL), 4.6 days (2-7 days). There was no serious postoperative complication except for one patient who showed delayed urinary leakage but was cured with conservative management. Our experience suggested that RPLU was not easy to perform simply because it was indicated mainly in ureter stones with severe adhesion or after failed SWL and/or URS. Nevertheless, it can be considered as a primary procedure before open ureterolithotomy.

Keyword

Laparoscopy; Ureteral Calculi; Ureterolithotomy, Retroperitoneal; Urinary Calculi

MeSH Terms

Urologic Surgical Procedures/*methods
Ureteral Calculi/*therapy
Ureter/pathology
Treatment Outcome
Time Factors
Sex Factors
Retroperitoneal Space/pathology
Peritoneum
Middle Aged
Male
Lithotripsy/*methods
Laparoscopy/*methods
Humans
Female
Adult

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