Comparison of therapeutic effects of transureteroscope holmium laser lithotripsy and retroperitoneal laparo-scopic ureterolithotomy for unilateral upper ureteral calculi

Abstract

Objective To compare the therapeutic effects of transureteroscope holmium laser lithotripsy （ URL） and retroperitoneal laparoscopic ureterolithotomy （ RLU） for unilateral upper ureteral calculi and evaluate the selection of indications and clinical value of URL and RLU .Methods 37 patients were enrolled into the study . 14 patients received URL ,23 patients received RUL .Double-J stent was routinely indwelled in both groups .The oper-ation time,hospitalization time,clearance rate of the stone and incidence of postoperative complications .Results The stone clearance rate after postoperation of RLU group was 100%, which was significantly higher than that of URL group 64.4%（χ2 =4.15,P〈0.05）.The mean operation time in RLU group was（132.0 ±7.8）min,which was sig-nificantly longer than URL group（46.5 ±7.2）min（t=6.23,P〈0.05）.The mean intraoperative blood loss of RLU group was（38.0 ±4.6）mL,which was significantly higher than URL group （10.0 ±3.2）mL（t=5.20,P〈0.05）. The postoperative complication rate of RLU group was 8.7%,which was significantly lower than URL group 21.5%（χ2 =4.06,P〈0.05）.There was no significant difference in hospitalization time and stone clearance rate between the two groups（P〉0.05）.Two cases converted to operation in URL group ,while only 1 case converted to operation in RLU group.Conclusion Laparoscopic ureterolithotomy has a higher stone clearance rate and shorter operation time compared with ureteroscopic lithotripsy .Laparoscopic ureterolithotomy is a safe and effective therapeutic method for unilateral upper ureteral stones . Key words: Ureteral stone; Laparoscopy; Ureteroscopy