Results of Laparoscopic Ureterolithotomy

A prospective study was carried out comparing retroperitoneoscopic and open ureterolithotomy (Table 5) (5). A total of 55 patients with large (mean size 2.1 cm) upper and mid-ureteric calculi with normal renal parameters were subjected to retroperito-neoscopic ureterolithotomy. In 22 patients, earlier attempts with shock wave lithotripsy and ureteroscopy had failed. These cases were compared with 26 cases (mean stone size, 2.4 cm) that underwent open ureterolithotomy during the same period. The two groups were similar to each other regarding patient age, sex, stone size, and stone location. Most stones were calcium based. Mean operating time and mean blood loss in the laparoscopic and open groups were 108.8 minutes versus 98.8 minutes, and 58.5 mL versus 50.5 mL, respectively (p = NS). Mean analgesic (pethidine) requirement and hospital stay were 41.1 mg versus 96.9 mg and 3.3 days versus 4.8 days, respectively (p < 0.001). Convalescence was quicker in the laparoscopic group: 1.8 weeks versus 3.1 weeks. The laparoscopic procedure has significant advantages over open surgery as regards analgesia, hospital stay, recuperation, and cosmesis. Retroperitoneal laparoscopy is a viable alternative for large upper and mid-ureteric calculus, and for those which have failed previous attempts at expert endourologic management.

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