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Introduction: With the advent of laparoscopic surgery,urologists once again found it necessary to traverse theperitoneal cavity in order to provide their patients with thebenefit of this less invasive type of surgery. In this study westudied the prevalence of laparoscopic urological surgeries,ergonomics involved, difficulties faced and complicationsrelated to laparoscopic procedures.Material and methods: It was a prospective hospitalbased non-randomised study carried out among 36 indoorcases operated using various laparoscopic procedures vizlaparoscopic pyeloplasty, laparoscopic pyelolithotomy,laparoscopic nephrectomy, laparoscopic ureterolithotomy etc.admitted under department of general surgery in a tertiaryhealthcare teaching instituteResults: In the present study, out of 31 cases, 20 casespresented with diagnosis of renal stone disease (Renal pelviccalculi, staghorn renal calculi and ureteric calculi). Total 5cases i.e 16.12% cases were having diagnosis of chronic nonfunctioning kidney while 3 cases (9.67%) were presented withrenal cell carcinoma. 3 cases (9.67%) presented with pelviureteric junction obstruction.Conclusion: Laparoscopic pyelolithotomy in extrarenal pelvisis a good procedure as pelvis can be reached easily especiallyif pelvis is dilated and Laparoscopic ureterolithotomy inabdominal ureter is a promising surgery as entire ureter canbe visualized so stones are easily detected and surgeon has abetter control of proximal ureter in case of slippage of calculas
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Objective To compare the clinical effect between percutaneous nephrolithotomy (PCNL) and retroperitoneal laparoscopic pyelolithotomy (RLP) in the treatment of renal pelvis calculus,so as to provide evidence for the treatment of renal pelvis calculus.Methods A total of 108 patients with renal pelvis calculus were selected from January 2012 to December 2016 in Zhumadian Central Hospital.The patients were divided into PCNL group (n =59) and RLP group (n =49) according to the therapeutic method.The operation time,intraoperative blood loss,intraoperative blood transfusion rate,operative success rate,stone clearance rate,postoperative hemoglobin reduction,postoperative analgesia time,postoperative hospitalization time and the incidence of complications were compared between the two groups.Results The success rate of operation in PC-NL group and RLP group was 94.9％ (56/59) and 100.0％ (49/49) respectively,there was no significant difference in the success rate of operation between the two groups (x2 =1.026,P ＞ 0.05).The stone clearance rate in PCNL group and RLP group was 94.9％ (56/59) and 98.0％ (48/49) respectively,there was no significant difference in the stone clearance rate between the two groups (x2 =0.140,P ＞ 0.05).The intraoperative blood transfusion rate in PCNL group and RLP group was 5.1％ (3/59) and 2.0％ (1/49) respectively,there was no significant difference in the intraoperative blood transfusion rate between the two groups (x2 =0.105,P ＞ 0.05).There was no significant difference in operation time and postoperative analgesia time between the two groups (P ＞ 0.05).Compared with the PCNL group,the blood loss and postoperative hemoglobin reduction were less,and the postoperative hospitalization time was shorter in the RLP group (P ＜ 0.05).The incidence of postoperative urinary leakage,urinary tract infection and secondary hemorrhage in PCNL group was 3.4％ (2/59),8.5％ (5/59)and 6.8％ (4/59) respectively;the incidence of postoperative urinary leakage,urinary tract infection and secondary hemorrhage in RLP group was 8.2％ (4/49),4.1％ (2/49) and 4.1％ (2/49) respectively;there was no significant difference in the incidence of postoperative urinary leakage,urinary tract infection and secondary hemorrhage between the two groups (x2 =2.975,1.064,1.811;P ＞ 0.05).Conclusion The clinical effect of PCNL and RLP in the treatment of renal pelvis calculus is fairly,and their safety is high.However,RLP has the advantages of less intraoperative bleeding,quick postoperative recovery and short hospitalization time.
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Objective To evaluate the efficacy of the retroperitoneal laparoscopic pyelolithotomy (RLP) and the percutaneous nephrolithotomy (PCNL) in treating renal pelvic stone.Methods The data of 89 patients diagnosed as renal pelvic stone were retrospectively reviewed from January 2009 to July 2016,of whom 43 patients underwent RLP and 46 underwent PCNL.Statistical analysis was performed regarding operation time,blood loss,mean hospital stay,complication rate,and stone-free rate.Results The operation time in RLP group and PCNL group was (117.5 ± 16.7) min and (118.3 ± 16.6) min,respectively,and there was no significant difference (P =0.547).For the two groups,the mean hospital stay was (4.5 ± 0.5) d and (6.1 ± 0.9) d,the mean hemoglobin decrease was (4.5 ± 1.2) g/L and (18.1 ± 3.4) g/L,the post-operative blood transfusion rate was 2.3％ and 14.0％,the post-operative septic shock rate was 0 and 9.3％,respectively,with significant difference between the two groups (P ＜ 0.05).The stone-free rate in both groups was 97.7％ and 95.3％ with no significant difference (P =0.557).Conclusions RLP has the advantages of quick recovery,less blood loss and lower complication rate than PCNL.It could be a minimally invasive option for the treatment of renal pelvic stone.
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Objective To evaluate the efficacy and safety of retroperitoneal laparoscopic pyelolithotomy ( RLP) combined with holmium laser lithotripsy under flexible cystoscopy in the treatment of complicated nephrolithiasis. Methods The retrospective analysis was made on the clinical data of 37 patients who underwent RLP and holmium laser lithotripsy under flexible cystoscopy for complicated nephrolithiasis from January 2013 to January 2014. The clinic parameters involved basic data of patients,operational time,blood loss,post-operative hospital stay,the status of stone-free,perioperative complications,and the follow-up data of patients were observed. Results No patient was converted to open surgery. The mean stone size was (2. 8 ± 0. 9) cm in diameter,operational time was (89 ± 24) min,blood loss was (21. 3 ± 7. 7) mL,post-operative hospital stay was (6. 8 ± 1. 7) d,the stone removal rate in one session was 94. 6%. One case occurred urinary leakage,1 case occurred fever after operation,who were all recovered through conservative treatment. All cases were followed up at the sixth months after operation. Conclusion RLP combined with holmium laser lithotripsy under flexible cystoscopy is effective and safe for the treatment of com-plicated nephrolithiasis.