KMID : 0358320090500040349
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Korean Journal of Urology 2009 Volume.50 No. 4 p.349 ~ p.354
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The Outcome of Laparoscopic Retroperitoneal Ureterolithotomy for the Management of Upper Ureteral Stones Larger than 10 mm: A Comparison with Rigid Ureteroscopic Removal of Stones with Lithoclast¢ç
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Park Woo-Jin
Kwon Jun-O Oh Tae-Hee
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Abstract
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Purpose: We evaluated the outcome of laparoscopic retroperitoneal ureterolithotomy (LRU) and compared the results with the rigid ureteroscopic removal of stones with the Lithoclast? (rigid URS) for the management of large upper ureteral stones (¡Ã10 mm).
Materials and Methods: Between July 2002 and March 2008, rigid URS and LRU were performed in 37 and 24 patients, respectively. We evaluated the outcomes of each procedure and compared the success rate according to the location (above and below the L3 level by the third intervertebral disc of the lumbar spine) and size of the stones (10-15 mm and ¡Ã15 mm in diameter).
Results: The overall success rate for rigid URS and LRU were 70.3% (26/37) and 91.7% (22/24), respectively (p=0.059). For rigid URS, the success rate was 50.0% (8/16) and 85.7% (18/21) for stones above and below the L3 level (p=0.030), respectively, and 85.7% (23/28) and 33.3% (3/9) for stones 10-15 mm and ¡Ã15 mm in diameter, respectively (p=0.011). For LRU, the success rate was 92.3% (12/13) and 90.9% (10/11) for stones above and below the L3 level, respectively (p=0.902), and 50.0% (1/2) and 95.5% (21/22) for stones 10-15 mm and ¡Ã15 mm in diameter, respectively.
Conslusions: LRU demonstrated a high success rate regardless of the location and size of the stones. The outcomes with rigid URS were more varied. These results suggest that LRU is a feasible alternative for large upper ureteral stones that are 15 mm or more in size or located above the intervertebral disc between the third and fourth lumbar vertebrae.
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KEYWORD
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Ureteral calculi, Ureteroscopy, Laparoscopy, Lithotripsy
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