Laparoscopic surgery for upper ureteral calculi in geriatric patients: 5 years experience

Abstract

Objective We have reviewed the success of laparoscopic calculi surgeries in geriatric patients. Methods A retrospective analysis was performed on the laparoscopic ureterolithotomy surgeries performed at our central between January 2014 and January 2019 to treat upper ureteral calculi in geriatric patients. Among the patients who underwent these surgeries, we evaluated data on 24 cases whose records could be fully retrieved. Results The age interval of the patients was 60–73 years, and the mean age was 63 ± 3.43 years. The size of the calculi was 19–24 mm, and mean size was 20.2 ± 2.5 mm. Because stone disease was present previously, 5 of these patients underwent endoscopic intervention, whereas two underwent open surgery. Sixteen of these patients had a history of unsuccessful shock wave lithotripsy (SWL) or ureterorenoscopy. The calculi-free rate was 100%. According to the modified Clavien classification, no major perioperative and postoperative complications were observed. The duration of hospital stay was 1–3 days, and the mean duration of stay was 1.6 ± 0.9 days. Conclusion We believe that owing to the high success and low complication rates, laparoscopic ureterolithotomy can be the first option of treatment for geriatric patients with impacted large calculi, with a history of unsuccessful SWL or ureterorenoscopy (semirigid, flexible).