Comparison of the Clinical Results and Complications of Retroperitoneal Laparoscopic Surgery with Open Surgery in the Renal Pelvis and Ureter Stones
Author(s): Alireza Farshi*, Rasoul Jafari, Mohsen Amjadi, Sakineh Hajebrahimi and Mona Mohiti Asli
Abstract
Purpose: The proper management of ureteral stones is essential due to the severity of symptoms and resulting kidney damage. Less invasive techniques such as ureteroscopy, shock wave lithotripsy, and percutaneous renal surgery have been proposed for the treatment of ureteral stones; however, they cannot entirely replace open surgery in patients with hard, large, prolonged, and impacted ureteral calculi. Recently, the use of laparoscopy in the treatment of ureteral stones has been considered. This study aimed to compare the clinical results and complications of retroperitoneal laparoscopic ureterolithotomy with open surgery in the renal pelvis and ureter stones.
Materials and Methods: In this clinical trial, 70 patients with ureter and pelvic stones referred to Imam Reza Hospital of Tabriz University of Medical Sciences were enrolled and divided into two groups (n=35 each) based on their desire. Patients in the first group underwent laparoscopic retroperitoneal surgery, and in the second group underwent open stone surgery. Age, sex, size and location of the stone, recovery, need for re-intervention, duration of surgery, and complications in both surgical methods were compared.
Results: Stones were successfully removed in all patients (100%) of the study groups. However, the incidence of postoperative complications in the retroperitoneal laparoscopic group was significantly lower than that of the open surgical group (p=0.023), wherein the retroperitoneal laparoscopic group, 29 (82.9%) patients, and in the open surgical group, 17 (48.6%) patients had no complications due to surgery.
Conclusion: Retroperitoneal laparoscopic ureterolithotomy of the renal pelvis and ureter stones is an effective method without complications and can be used as an alternative to open surgery.