RESUMEN
【Objective】 To evaluate the efficacy and safety of 3-dimensional laparoscopic pyeloplasty and ultrasound-guided flexible ureteroscopy lithotripsy (3DLP-UGFURL) in the treatment of ureteropelvic junction obstruction (UPJO) and renal calculi. 【Methods】 The clinical data of 29 patients of UPJO complicated with renal calculi treated with 3DLP-UGFURL during Dec.2017 and Jul.2022 were retrospectively analyzed. There were 23 males and 6 females with average age of (35.3±13.6) years. The lesions were on the left side in 20 cases, on the right side in 9 cases, and all were unilateral. One case was complicated with horseshoe kidney. The body mass index (BMI) was 23.6±3.9. Multiple calculi of renal pelvis or calyces occurred in 16 cases, and the rest were single calculi. The maximum diameter of calculi was (1.2±0.6)cm. There were 2 cases of mild hydronephrosis, 19 cases of moderate hydronephrosis and 8 cases of severe hydronephrosis. 【Results】 All operations were successful. The operation time of 3DLP was (84.2±15.4)min. Operation time of UGFURL was (42.8±15.7)min. Estimated blood loss was (36.9±13.6)mL. Indwelling time of drainage tube was (3.6±1.6)d. Indwelling time of urinary catheter and postoperative hospital stay was (6.8±1.2)d. One month after operation, the stone removal rate was 97.4%. The retention time of ureteral stent was 2.7 months. During the follow-up of (24.5±10.0)months, there were 45 Clavien Dindo grade 1 complications. 【Conclusion】 3DLP-UGFURL is safe and effective in the treatment of UPJO complicated with renal calculi, but it still needs long-term follow-up data.
RESUMEN
Objective To assess the perioperative safety and postoperative function of the pure 3-dimensional laparoscopic cystectomy and urinary diversion (P3DLC-UD).Methods From April 2014 to July 2015,P3DLC-UD was performed in 15 patients diagnosed with the bladder cancer in our center (orthotopic ileal neobladder for 8 cases and ileal conduit for 7 cases).Perioperative data,postoperative continence and overall survival rate were retrospectively analyzed.Results Fifteen patients underwent P3DLC-UD successfully as planned,with 8 patients underwent orthotopic ileal neobladder and 7 patients underwent ileal conduit.In neobladder group,the operative time were 300-600mmin (mean 428 min),estimated blood loss were l 00-400ml (mean 210mml),and dissected lymph nodes were 11-29 (mean 16).One patient required blood transfusion (800ml) and one patient was diagnosed of constipation.The patients were followed up for a median period of 10 months (3-15 months).The renal function was normal with serum creatinine of 36.4-99.0 μ mol/L (mean 77.3 μmol/L).One patient died of intestinal obstruction and 8 patients had no recurrence in neobladder group.As to postoperative continence,only 2 patients demanded 1 pad at daytime,while all patients needed 1 pad at nighttime.In ileal conduit group,the operative time were 300-390 min (mean 354 min),estimated blood loss were 50-400ml (mean 190ml),and dissected lymph nodes were 9-41 (mean 22),while 9-41 (mean 19) lymph nodes were got for all 15 cases.Two patients were diagnosed with urinary infection after the surgery.The patients were followed up for a median period of 5 months (1-9 months).The renal function was normal with serum creatinine of 36.4-74.0 μmol/L (mean 60.8 μmol/L).One patient died of cerebral infarction,and 1 patient found distant metastases in lung and died of cancer after chemotherapy during the follow-up period.There were no recurrent tumors of the other 5 patients in ileal conduit group.Conclusions P3DLC-UD is safe and feasible.More extensive,longer-term randomized trials are required to comprehensively assess the appropriateness and potential of this technique.