Abstract
Amaç: Minimal invaziv üroloji prosedürlerinin gelişmesiyle, üreter taşlarının tedavisinde açık cerrahi girişimler daha az kullanılmaktadır. Laparoskopik üreterolitotomi (LU) endikasyonları şok dalgası litotripsi veya üreterorenoskopi ile tedavi edilemeyen büyük, çoklu ve / veya impakte üreter taşlarıdır. Bu çalışmada laparoskopik retroperitoneal ve transperitoneal üreterolitotomi tekniklerini karşılaştırmayı ve hangi prosedürün daha etkili olduğunu saptamayı amaçladık.
Gereç ve Yöntemler: Ocak 2012-Aralık 2017 tarihleri arasında büyük ve impakte üst üreter taş nedeniyle transperitoneal ve retroperitoneal LU uygulanan 45 hastayı değerlendirdik. Retroperitoneal ve transperitoneal yöntemler sırasıyla grup 1 ve grup 2 olarak sınıflandırıldı. Gruplar preoperatif, intraoperatif ve postoperatif klinik bulgulara göre karşılaştırıldı.
Bulgular: Gruplar arasında yaş, cinsiyet, taş büyüklüğü, kan kaybı ve vücut kitle indeksi açısından istatistiksel olarak anlamlı bir farklılık bulunmadı. Taşsızlık oranı her 2 grupta da %100 idi. VAS skorları grup 1'de istatistiksel olarak daha yüksek saptandı (p <0.05). Ortalama ameliyat süresi grup 2'de istatistiksel olarak daha kısa bulundu (p: 0.022). İntraoperatif hiçbir hastaya rutin double J stent konulmadı.
Sonuç: Transperitoneal yöntemle karşılaştırıldığında, retroperitoneal teknik, büyük ve impakte proksimal üreter taşlarının tedavisinde anlamlı olarak daha kısa ameliyat süresine ve daha az postoperatif ağrı oranına sahiptir.
Keywords
Supporting Institution
Yok
Project Number
Yok
References
- 1. Lopes Neto A.C., Korkes F., Silva J.L., et al. Prospective randomized study of treatment of large proximal ureteral stones: extracorporeal shock wave lithotripsy versus ureterolithotripsy versus laparoscopy. J Urol 2012; 187:164-68.
- 2. Fang YQ, Qiu JG, Wang DJ, et al. Comparative study on ureteroscopic lithotripsy and laparoscopic ureterolithotomy for treatment of unilateral upper ureteral stones. Acta Cir Bras. 2012 Mar; 27(3):266-70
- 3. Huri E, Basok EK, Ugurlu O, et al. Experiences in laparoscopic removal of upper ureteral stones: multicenter analysis of cases, based on the Turk Uro Lap Group. J Endourol 2010; 24:1279-82.
- 4. Tugcu V, Simsek A, Kargi T, et al. Retroperitoneal Laparoendoscopic single site ureterolithotomy versus conventional laparoscopic ureterolithotomy. Urology 2013; 81:567-72.
- 5. Gaur DD, Trivedi S, Prabhudesai MR, et al. Laparoscopic ureterolithotomy: technical considerations and long-term follow-up. BJU Int 2002; 89:339.
- 6. Khaladkar S, Modi J, Bhansali M, et al. Which is the best option to treat large (>1.5cm) midureteric calculi? J Laparoendoscopic? Adv Surg Tech A 2009; 19: 501-04.
- 7. Tefekli A, Karadag MA, Tepeler K, et al. Classifications of percutaneous nephrolithotomy complications using the modified Clavien grading system: looking for a standard. Eur Urol 2008; 53:184-90.
- 8. Rabani SM, Moosavizadeh A. Management of Large Proximal Ureteral Stones: A Comparative Clinical Trial Between Transureteral Lithotripsy (TUL) and Shock Wave lithotripsy (SWL). Nephrourol Mon. 2012 Summer; 4(3):556-9.
- 9. Türk C, Knoll T, Petrik A, Sarica K, Straub M, Seitz C: EAU Guidelines on Urolithiasis: 5.7 Open and laparoscopic surgery for removal of renal stones. EAU Guideline, 2012, pp 4748.
- 10. Wickham JEA (ed). The surgical treatment of renal lithiasis. In: Urinary Calculus Disease. New York: Churchill Livingstone 1979; 145-98.
- 11. Raboy A, Ferzli GS, Ioffreda R, et al. Laparoscopic ureterolithotomy. Urology 1992; 39:223-25.
- 12. Gaur DD: Retroperitoneal endoscopic ureterolithotomy: our experience in 12 patients. J Endourol 1993; 7:501.
- 13. Harewood LM, Webb DR, Pope AJ. Laparoscopic ureterolithotomy: the results of an initial series, and an evaluation of its role in the management of ureteric calculi. Br J Urol 1994; 74: 170-76.
- 14. McAllister M, Bhayani SB, Ong A, et al. Vena cava transection during retroperitoneoscopic nephrectomy: report of the complication and review of the literature. J Urol 2004; 172:183-5.
- 15. Sancaktutar AA, Bozkurt Y, Atar M, et al. Urological laparoscopic surgery: Our experience of first 100 cases in Dicle University. J Clin Exp Invest 2012; 3:44-8.
- 16. Singh V, Sinha RJ, Gupta DK, et al. Transperitoneal Versus Retroperitoneal Laparoscopic Ureterolithotomy: A Prospective Randomized Comparison Study. J Urol 2013; 189:940-5.
- 17. Rofeim O, Yohannes P, Badlani G. Does laparoscopic ureterolithotomy replace shock-wave lithotripsy or ureteroscopy for ureteral stones? Curr Opin Urol 2001; 11:287-91.
- 18. Feyaerts A, Rietbergen J, Navarra S, et al. Laparoscopic ureterolithotomy for ureteral calculi. Eur Urol. 2001; 40:609-613 VE Gaur DD, Rathi SS, Ravandale AV, et al. A single centre experience of retroperitoneoscopy using the balloon technique. BJU Int. 2001; 87:602-606).
- 19. Bove P, Micali S, Miano R, et al. Laparoscopic ureterolithotomy: a comparison between the transperitoneal and the retroperitoneal approach during the learning curve. J Endourol 2009; 23:953-7.
- 20. Flasko T, Holman E, Kovacs G, et al. Laparoscopic ureterolithotomy: the method of choice in selected cases. JLaparoendoscAdvSurgTechA.2005;15:149-52.
- 21. Kaygısız O, Coşkun B, Kılıçarslan H, et al. Comparison of Ureteroscopic Laser Lithotripsy with Laparoscopic Ureterolithotomy for Large Proximal and Mid-Ureter Stones Urol Int 2015; 94:205-09.
- 22. Karami H, Javanmard B, Hasanzadeh-Hadah A, et al. Is it necessary to place a Double J catheter after laparoscopic ureterolithotomy? A four-year experience. J Endourol 2012; 26:1183-86.
- 23. Bellman GC, Smith AD. Specialconsiderationsinthetechnique of laparoscopic ureterolithotomy. J Urol 1994; 151:146-49.
- 24. Hammady A, Gamal WM, Zaki M, et al. Evaluation of ureteral stent placement after retroperitoneal laparoscopic ureterolithotomy for upper ureteral stone: randomized controlled study. J Endourol 2011; 25:825.
- 25. Kijvikai K and Patcharatrakul S: Laparascopic ureterolithotomy: its role and some controversial technical considerations: İnt J Urol 2006; 13:206.
- 26. Nouira Y, Kallel Y, Binous MY, et al. Laparoscopic retroperitoneal ureterolithotomy: initial experience and review of literature. J Endourol 2004; 18:557-61.
Abstract
Objectives: With the improvement of minimally invasive urology procedures, open surgical interventions are less common to treat ureteral calculus. Laparoscopic ureterolithotomy (LU) indications are large multiple and/or impacted ureteral calculus that may not be treated with shock-wave lithotripsy or ureterorenoscopy approaches. We aimed to collate laparoscopic retroperitoneal and transperitoneal ureterolithotomy techniques and to identify which procedure is more effective.
Material and Methods: We reviewed 45 patients with large and impacted upper ureter calculus who underwent transperitoneal or retroperitoneal LU between January 2012 and December 2017. The retroperitoneal and transperitoneal routes were grouped as group 1 and 2, respectively. Groups were crosschecked according to preoperative, intraoperative, and postoperative clinical datum.
Results: We did not find statistically meaningful disparity between groups with regards to age, gender, stone size, blood loss and body mass index. The stone free accomplishment ratio was 100% in group 1 and 2. VAS scores were higher and statistically meaningful in group 1 (p<0.05). The mean operative time was statistically shorter in group 2 (p:0.022). No double J stent inserted routinely intraoperatively.
Conclusion: Compared to those obtained with the transperitoneal technique, the retroperitoneal technique has a significantly shorter operating time and less postoperative pain for large and impacted proximal ureteral calculus. More randomized, controlled and prospective studies on large samples are needed.
Keywords
Project Number
Yok
References
- 1. Lopes Neto A.C., Korkes F., Silva J.L., et al. Prospective randomized study of treatment of large proximal ureteral stones: extracorporeal shock wave lithotripsy versus ureterolithotripsy versus laparoscopy. J Urol 2012; 187:164-68.
- 2. Fang YQ, Qiu JG, Wang DJ, et al. Comparative study on ureteroscopic lithotripsy and laparoscopic ureterolithotomy for treatment of unilateral upper ureteral stones. Acta Cir Bras. 2012 Mar; 27(3):266-70
- 3. Huri E, Basok EK, Ugurlu O, et al. Experiences in laparoscopic removal of upper ureteral stones: multicenter analysis of cases, based on the Turk Uro Lap Group. J Endourol 2010; 24:1279-82.
- 4. Tugcu V, Simsek A, Kargi T, et al. Retroperitoneal Laparoendoscopic single site ureterolithotomy versus conventional laparoscopic ureterolithotomy. Urology 2013; 81:567-72.
- 5. Gaur DD, Trivedi S, Prabhudesai MR, et al. Laparoscopic ureterolithotomy: technical considerations and long-term follow-up. BJU Int 2002; 89:339.
- 6. Khaladkar S, Modi J, Bhansali M, et al. Which is the best option to treat large (>1.5cm) midureteric calculi? J Laparoendoscopic? Adv Surg Tech A 2009; 19: 501-04.
- 7. Tefekli A, Karadag MA, Tepeler K, et al. Classifications of percutaneous nephrolithotomy complications using the modified Clavien grading system: looking for a standard. Eur Urol 2008; 53:184-90.
- 8. Rabani SM, Moosavizadeh A. Management of Large Proximal Ureteral Stones: A Comparative Clinical Trial Between Transureteral Lithotripsy (TUL) and Shock Wave lithotripsy (SWL). Nephrourol Mon. 2012 Summer; 4(3):556-9.
- 9. Türk C, Knoll T, Petrik A, Sarica K, Straub M, Seitz C: EAU Guidelines on Urolithiasis: 5.7 Open and laparoscopic surgery for removal of renal stones. EAU Guideline, 2012, pp 4748.
- 10. Wickham JEA (ed). The surgical treatment of renal lithiasis. In: Urinary Calculus Disease. New York: Churchill Livingstone 1979; 145-98.
- 11. Raboy A, Ferzli GS, Ioffreda R, et al. Laparoscopic ureterolithotomy. Urology 1992; 39:223-25.
- 12. Gaur DD: Retroperitoneal endoscopic ureterolithotomy: our experience in 12 patients. J Endourol 1993; 7:501.
- 13. Harewood LM, Webb DR, Pope AJ. Laparoscopic ureterolithotomy: the results of an initial series, and an evaluation of its role in the management of ureteric calculi. Br J Urol 1994; 74: 170-76.
- 14. McAllister M, Bhayani SB, Ong A, et al. Vena cava transection during retroperitoneoscopic nephrectomy: report of the complication and review of the literature. J Urol 2004; 172:183-5.
- 15. Sancaktutar AA, Bozkurt Y, Atar M, et al. Urological laparoscopic surgery: Our experience of first 100 cases in Dicle University. J Clin Exp Invest 2012; 3:44-8.
- 16. Singh V, Sinha RJ, Gupta DK, et al. Transperitoneal Versus Retroperitoneal Laparoscopic Ureterolithotomy: A Prospective Randomized Comparison Study. J Urol 2013; 189:940-5.
- 17. Rofeim O, Yohannes P, Badlani G. Does laparoscopic ureterolithotomy replace shock-wave lithotripsy or ureteroscopy for ureteral stones? Curr Opin Urol 2001; 11:287-91.
- 18. Feyaerts A, Rietbergen J, Navarra S, et al. Laparoscopic ureterolithotomy for ureteral calculi. Eur Urol. 2001; 40:609-613 VE Gaur DD, Rathi SS, Ravandale AV, et al. A single centre experience of retroperitoneoscopy using the balloon technique. BJU Int. 2001; 87:602-606).
- 19. Bove P, Micali S, Miano R, et al. Laparoscopic ureterolithotomy: a comparison between the transperitoneal and the retroperitoneal approach during the learning curve. J Endourol 2009; 23:953-7.
- 20. Flasko T, Holman E, Kovacs G, et al. Laparoscopic ureterolithotomy: the method of choice in selected cases. JLaparoendoscAdvSurgTechA.2005;15:149-52.
- 21. Kaygısız O, Coşkun B, Kılıçarslan H, et al. Comparison of Ureteroscopic Laser Lithotripsy with Laparoscopic Ureterolithotomy for Large Proximal and Mid-Ureter Stones Urol Int 2015; 94:205-09.
- 22. Karami H, Javanmard B, Hasanzadeh-Hadah A, et al. Is it necessary to place a Double J catheter after laparoscopic ureterolithotomy? A four-year experience. J Endourol 2012; 26:1183-86.
- 23. Bellman GC, Smith AD. Specialconsiderationsinthetechnique of laparoscopic ureterolithotomy. J Urol 1994; 151:146-49.
- 24. Hammady A, Gamal WM, Zaki M, et al. Evaluation of ureteral stent placement after retroperitoneal laparoscopic ureterolithotomy for upper ureteral stone: randomized controlled study. J Endourol 2011; 25:825.
- 25. Kijvikai K and Patcharatrakul S: Laparascopic ureterolithotomy: its role and some controversial technical considerations: İnt J Urol 2006; 13:206.
- 26. Nouira Y, Kallel Y, Binous MY, et al. Laparoscopic retroperitoneal ureterolithotomy: initial experience and review of literature. J Endourol 2004; 18:557-61.
Details
| Primary Language | English |
|---|---|
| Subjects | Urology |
| Journal Section | Research Articles |
| Authors | |
| Project Number | Yok |
| Publication Date | July 23, 2020 |
| Published in Issue | Year 2020 Volume: 12 Issue: 2 |
