Concomitant treatment of robot-assisted laparoscopic surgery and flexible ureteroscope lithtripsy for ureteropelvic junction obstruction with renal calculi
Wang Fuli1, Yang Lijun1, Liu Fei1, Wang Yanzhu1, Meng Ping1, Wu Peng1, Yang Xiaojian1, Qin Weijun1, Yuan Jianlin1
1Department of Urology, Xijing Hospital, the Fourth Military Medical University, Xi'an 710032, China
Abstract：Objective: To evaluate the efficacy and feasibility of the robot-assisted laparoscopic pyeloplasty (RALP) combined with flexible ureteroscope lithtripsy (f-URL) for treatment of ureteropelvic junction obstruction (UPJO) with renal calculi. Methods: We retrospectively reviewed the records of 12 patients who underwent RALP and f-URL for UPJO with renal calculi from March 2013 to September 2015. Three cases had solitary stones located at the lower calyx, and the other two had multiple stones. Of 12 cases of UPJO, there were 7 cases in the right kidney, and 5 cases in the left kidney. Seven cases had solitary stones located at the lower calyx, and the rest 5 cases had multiple stones. B-ultrasound examination showed that severe hydronephrosis occurred in 4 cases, intermediate in 5 cases, and mild in 3 cases. Results: The operation was successful in all the 12 patients with no severe complications. The average total operation time was (128.6±26.3) min and the average f-URL time was (30.2±13.5) min. The average blood loss was (37.1±9.7) mL and the average hospital stay length was (6.2±1.5) days. No conversions to open surgery were required. During the postoperative follow-up period of 12 to 42 months, the stone-free rate was 100%. Lumbago disappeared in 12 cases and there was no stricture at UPJ by retrograde pyelography. Hydronephrosis was remitted (among 4 cases with severe hydronephrosis, hydrops remitted from severe to interm ediate in 1 and to mild in 3; among 5 cases with intermediate hydronephrosis, hydrops remitted from interm ediate to mild in 2 and 3 had resolution: 3 cases with mild hydronephrosis had resolution). Conclusions: RALP combined with f-URL is effective and feasible for treatment of UPJO with renal calculi.
王福利,杨力军,刘飞,杨晓剑,王延柱,孟平,武鹏,张龙龙,秦卫军,袁建林. 机器人辅助腹腔镜联合输尿管软镜治疗合并肾结石的肾盂输尿管连接部梗阻[J]. 微创泌尿外科杂志, 2017, 6(2): 78-81.
Wang Fuli, Yang Lijun, Liu Fei, Wang Yanzhu, Meng Ping, Wu Peng, Yang Xiaojian, Qin Weijun, Yuan Jianlin. Concomitant treatment of robot-assisted laparoscopic surgery and flexible ureteroscope lithtripsy for ureteropelvic junction obstruction with renal calculi. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2017, 6(2): 78-81.
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