Abstract

Background: Ureteric stones are a common clinical issue, often necessitating open ureterolithotomy for large and impacted upper ureteric stones. Despite its success, laparoscopic surgery has gained popularity as an alternative approach, offering potential benefits such as reduced morbidity and shorter hospital stays. This study aims to compare the outcomes of laparoscopic ureterolithotomy with open ureterolithotomy for large impacted stones in the upper ureter. Methods: A prospective quasi-experimental study was conducted from June 2018 to August 2019 at the Department of Urology, Dhaka Medical College Hospital. The study enrolled sixty patients with upper ureteric stones larger than 2 cm. Patients were divided into two groups: Group A underwent laparoscopic ureterolithotomy, while Group B underwent open ureterolithotomy. Demographic data, medical history, examination findings, and investigation reports were recorded for all patients. Post-surgical pain scores, blood loss, complications, and hospital stays were also evaluated. Results: The study compared the outcomes of Group-A and Group-B patients who underwent ureterolithotomy. Group-A had an average age of 49.66 ± 14.70 years, while Group-B's average age was 51.60 ± 11.93 years. There was no significant difference in gender distribution between the groups (p-value 0.371). Group-A had a mean operative time of 2.11 ± 0.41 hours, while Group-B had a mean operative time of 1.60 ± 0.28 hours. Laparoscopic ureterolithotomy resulted in significantly less blood loss (p-value <0.001). Group-A had a lower mean pain score (59.27 ± 8.56) compared to Group-B (75.50 ± 17.34). Laparoscopic ureterolithotomy also required less Pethidine (p-value <0.001). Group-A experienced 6.7% wound infection and 10% UTI, while Group-B had higher rates (26.7% and 33.3% respectively). Urine extravasation occurred in 16.7% of Group-A, on the hand, in Group-B, it was 6.7%. Group-A had a shorter hospital stay (4.17 ± 1.18 days) compared to ........

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