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VOLUME 2 , ISSUE 3 ( September-December, 2009 ) > List of Articles

REVIEW ARTICLE

Transperitoneal Laparoscopic Ureterolithotomy versus Retroperitoneoscopic Ureterolithotomy

Mark C Cellona

Citation Information : Cellona MC. Transperitoneal Laparoscopic Ureterolithotomy versus Retroperitoneoscopic Ureterolithotomy. World J Lap Surg 2009; 2 (3):47-52.

DOI: 10.5005/jp-journals-10007-1036

Published Online: 01-12-2009

Copyright Statement:  Copyright © 2009; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background and purpose

Most ureterolithiasis that require surgical management are currently managed with minimally invasive procedures like shockwave lithotripsy, ureteroscopy with lithotripsy and percutaneous nephrolithotripsy. In cases where the above procedures will most likely fail or has failed, laparoscopic ureterolithotomy in either transperitoneal laparoscopic ureterolithotomy (TPUL) or retroperitoneoscopic ureterolithotomy (RPU) is a viable option compared to open ureterolithotomy. The goal of this review is to compare the effectiveness and safety of transperitoneal laparoscopic ureterolithotomy and retroperitoneoscopic ureterolithotomy in the treatment of large, chronically impacted ureterolithiasis or as salvage treatment after failed shockwave lithotripsy, ureteroscopy and percutaneous nephrolithotomy by reviewing patient selection, operative time, blood loss, hospital stay, complications, open conversion rate and success rate.

Material and methods

A systematic literature search was performed using Highwire press, Medline, Springer link, Medscape, Google and article bibliographies to identify relevant references. Included studies must have reported outcome data for more than 20 patients with a minimum follow-up of 3 months. Stone size, operating time, blood loss, hospital stay, complications, open conversion rate and success rate were reviewed.

Aims and objectives

The aim of this study was to compare the effectiveness and safety of transperitoneal laparoscopic ureterolithotomy (TPUL) and retroperitoneoscopic ureterolithotomy (RPU) in the surgical management of ureterolithiasis. The following parameters were evaluated for both procedures.

1. Operative technique.

2. Stone size.

3. Operating time.

4. Hospital stay.

5. Intraoperative and postoperative complications.

6. Open conversion rate.

7. Success rate.

Conclusion

Transperitoneal Ureterolithotomy and retroperitoneoscopic ureterotomy were both effective procedures in the management of ureterolithiasis. Both procedures are comparable in terms of blood loss, hospital stay and success rates. RPU seemed to have a higher complication and open conversion rate compared to TPUL.


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