Retroperitoneoscopic ureterolithotomy for upper ureteral calculi / 中国微创外科杂志

ABSTRACT

Objective To evaluate the clinical signifi ca nce of retroperitoneoscopic ureterolithotomy for upper ureteral calculi. Methods Retroperitoneoscopic ureterolithotomy was carried out in 22 p atients with upper ureteral calculi. The operation was performed in the retroper itoneal space. After the upper ureter and calculi were exposed, a scalpel was ut ilized to cut the ureter longitudinally for the removal of calculi. A double-J t ube was inserted into the ureter routinely and the ureterotomy closure was perfo rmed with sutures. Results A conversion to open surgery was needed in 1 patient because the calculi had moved into the kidney. One patient e xperienced urinary leakage at 500～800 ml/d postoperatively, and received an ope n surgery of double-J tube insertion 3 days later. Of the remaining 20 patients, the procedure was successfully accomplished, with the operation time of 50~240 min (mean, 110 min) and the blood loss of 30~100 ml (mean, 50 ml). The time to t he recovery of intestinal functions was 12~30 h (mean, 18 h).The postoperative h ospital stay was 5~8 days (mean, 6.8 days). Follow-up with B-ultrasonography and intravenous urethrography for 1~12 months in the 20 patients found no residual calculi or ureteral stricture. Hydronephrosis disappeared in 15 patients and mil d hydronephrosis was detected in the rest of 5 patients. Conclusions Retroperitoneoscopic ureterolithotomy is a safe and effective option for upper ureteral calculi. It may be considered as the first-line treatment for re latively large-sized upper ureteral calculi.