Evaluation of minimally invasive surgical treatment of the complicated upper ureteric calculi

Abstract

Objective To evaluate the effect of the percutaneous nephrolithotomy （PCNL） in the manage- ment of complicated upper ureterie calculi, compared with retroperitoneal laparoscopie ureterolithotomy （RLU）. Methods Seventy-one cases with complicated upper ureteric calculi were retrospectively investigated （PCNL group 23 cases, RLU group 29 eases）. Clinical data including operation time, stone free rate and the surgical complications were statistically analyzed. Results , All the operations were successful in all 52 cases. Compared with the RLU group, the PCNL group had a significant shorter operation time [ （45.12 ± 11.56 ） min vs （ 82.03 ± 12.45 ） min, t = 10.13 ,P 〈 0.01 ] , and significant difference were detected. A week after the operation, the PCNL group showed a stone free rate of 95.6% （22/23） while the RLU group 100.0% （29/29）, and no significant difference were detec- ted. No significant complications, such as intraoperative or postoperative bleeding and damage to surrounding organs, were detected. The patients were followed up for 6 to 12 months （mean,9 months） , and no recurrent stones or ureteral stricture were developed during the period. Conclusion Both PCNL and RLU are safe and effective for complicated upper ureteral calculi. The appropriate method depends on the patients＇ specific conditions,the unit equipments and the experience of operator. Key words: Ureteral calculi ; Prcutaneous nephrolithotomy ; Laparoscopic ureterolithotomy