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Evaluation of laparoscopic retroperitoneal surgery in urinary stone disease.

Abstract：

PURPOSE:To assess the safety and effectiveness of laparoscopic retroperitoneal surgery and attempt to define its role in the management of urolithiasis. PATIENTS AND METHODS:Laparoscopic retroperitoneal surgery (LRS) was undertaken in 72 male and 42 female patients with calculous disease from March 1994 to April 2000 for variety of indications that otherwise would have made them candidates for conventional open surgery. Some of these patients were subjected to retroperitoneoscopic ureterolithotomy (RPUL) (40 patients) and retroperitoneoscopic pyelolithomy (RPPL) (7 patients). Retroperitoneoscopic nephrectomy (RPN) and nephroureterectomy (RPNUT) for a nonfunctioning renal unit secondary to renal and or ureteral calculi was done in 53 and 14 patients, respectively. Most of the procedures were performed with three 10-mm ports. In some cases, an additional 5-mm port was used. RESULTS:The procedure was successful in 75%, 71%, 90.5%, and 86% of cases subjected to RPUL, RPPL, RPN, and RPNUT, respectively. The mean operating time for RPUL was 106.3 minutes and for RPPL was 108.2 minutes, whereas it was 99.7 minutes for RPN and 147 minutes for RPNUT of nonfunctioning kidneys secondary to calculous disease. The major complications encountered were colon injury in one patient with calculous pyonephrosis who had dense adhesions and injury to the external iliac artery in another patient having RPUL. The mean blood loss was 69.8, 127.2, 135.6, and 206.5 mL, respectively, for RPUL, RPPL, RPN, and RPNUT. The average hospital ranged from 3 to 4 days. CONCLUSIONS:Laparoscopic retroperitoneal surgery has a definite role in the management of patients requiring open surgery for calculous disease. It is safe and feasible in spite of the dense adhesions that are frequently encountered in such patients. Often, previous attempts at treatment with shockwave lithotripsy or endourologic procedures also lead to inflammation and adhesions, making surgery difficult. However, these problems can be dealt with by LRS with good results.

journal_name

J Endourol

journal_title

Journal of endourology

authors

Hemal AK,Goel A,Kumar M,Gupta NP

doi

10.1089/08927790152596271

subject

Has Abstract

pub_date

2001-09-01 00:00:00

pages

701-5

issue

eissn

0892-7790

issn

1557-900X

journal_volume

pub_type

临床试验,杂志文章

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Evaluation of laparoscopic retroperitoneal surgery in urinary stone disease.