Korean J Urol.  2014 Aug;55(8):511-514. 10.4111/kju.2014.55.8.511.

Should We Place Ureteral Stents in Retroperitoneal Laparoscopic Ureterolithotomy?: Consideration of Surgical Techniques and Complications

• You JH
• Kim YG
• Kim MK

• KMID: 1794584
• DOI: http://doi.org/10.4111/kju.2014.55.8.511

Abstract

PURPOSE
There is some debate over the necessity of ureteral stenting after laparoscopic ureterolithotomy. We evaluated the need for ureteral stenting after retroperitoneal laparoscopic ureterolithotomy (RLU).
MATERIALS AND METHODS
Between January 2009 and January 2013, 41 patients underwent RLU to remove upper ureteral stones. The retroperitoneal approach was used in all patients by a single surgeon. A double J (D-J) stent was placed in the first 17 patients after the procedure but not in any of the next 24 patients.
RESULTS
The mean patient age, serum creatinine levels, and stone size were not significantly different between the two groups. The stone-free rate was 100%. The mean operative time was significantly shorter in the stentless group than in the stent group (59.48 minutes vs. 77.88 minutes, p<0.001). Parenteral analgesic use and anticholinergic medication use were observed in the stent group only. The blood loss, drain removal day, and hospital stay were not significantly different between the two groups. No other significant complications occurred during or after the operation in any patients.
CONCLUSIONS
RLU is a safe and effective treatment modality for large impacted ureteral stones. In this study, D-J stent placement was not necessary after RLU. In the future, large-scale studies of RLU without D-J stenting, especially on the frequency of the development of complications according to the surgical technique, may be needed.

Keyword

Laparoscopy; Ureteral calculi; Ureteral catheter

MeSH Terms

Adult
Aged
Creatinine/blood
Female
Humans
Intraoperative Period
Laparoscopy/adverse effects/*methods
Male
Middle Aged
Retroperitoneal Space/surgery
Retrospective Studies
*Stents
Treatment Outcome
Unnecessary Procedures
Ureter/*surgery
Ureteral Calculi/*surgery
Creatinine

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