[Subsequent retroperitoneoscopy for patients with previous ipsilateral retroperitoneal surgery].

OBJECTIVE: To evaluate the feasibility and clinical results of subsequent retroperitoneoscopic surgery for patients with previous ipsilateral retroperitoneal surgery through frank incision. METHODS: A total of 10 patents were selected for subsequent laparoscopic surgery through retroperitoneal approach. Among them, there were recurrent renal cysts (n = 4) including a history of open surgery (n = 1) and retroperitoneal surgery (n = 3) and nonfunctional kidneys (n = 6) including open nephropyelopolasty (n = 3), retroperitoneoscopic nephropyelopolasty (n = 1) and retroperitoneoscopic ureterolithotomy (n = 2). The mean surgical duration was (12-85) 38.6 months. All patients underwent retroperitoneoscopy. Decortication was performed for renal cysts and nephrectomy for nonfunctional kidneys. RESULTS: All operations were successfully performed with a mean surgical duration of 97 (40-185) minutes and a mean volume of blood loss 125 (20-460) ml. Among 4 cases with intraoperative peritoneal rupture, one case had renal cyst on ventral side. After enlargement, the procedure was performed through peritoneal cavity. The mean postoperative hospital stay was 5.6 (3-9) days. Nine patients received a mean follow-up period of 21.5 (3-47) months. All symptoms were relieved without any occurrence of postoperative complications. CONCLUSION: For patients with previous ipsilateral retroperitoneal surgery, retroperitoneoscopy may be feasible for properly selected cases.

[Preventive strategies and causes of common complications of ureteroscopy].

OBJECTIVE: To discuss the causes of common complications of ureteroscopy and how to prevent them. METHODS: A total of 768 cases of common complications of ureteroscopy were retrospectively analyzed from February 2004 to February 2009. RESULTS: The intra-operative complications were failed entry (n = 6, 0.78%), ureterostoma injury and ureterostoma submucosa pseudocana (n = 12, 1.56%), ureteral perforation (n = 16, 2.08%), stone displacement (n = 13, 1.87%) and ureteral mucosa evulsion (n = 3, 0.39%). And the post-operative complications were lumbago or renal colic (n = 11, 1.43%), infection (n = 9, 1.17%)and severe hematuria (n = 5, 0.65%). CONCLUSION: Skillful operative techniques and strict indications are key to reducing complications of ureteroscopy.