Laparoscopic ureterolithotomy in treatment of impacted upper ureteral calculi below the third lumbar vertebra via transperitoneal approach
Wang Ping1,Sun Xingchun1,Mao Jie1,Zhu Rui1,Yang Jiwei1,Yan Yongji2
1Department of Urology, People's Hospital of Yiliang County, Yunnan 652100, China;2Third Unit of Department of Urology, the Second Affiliated Hospital of Kunming Medical University
Abstract：Objective:To explore the method and clinical value of laparoscopic ureterolithotomy in treatment of impacted upper ureteral calculi below the third lumbar vertebra via transperitoneal approach. Methods:From January 2013 to February 2014, laparoscopic ureterolithotomy was carried out on 18 patients with impacted upper ureteral calculi via transperitoneal access. Of all patients, 7 had been treated with ESWL before. The mean stone size was 2.1 cm (range 1.3 to 3.0 cm). Results:Laparoscopic ureterolithotomy was successfully performed on all cases without conversion to open surgery. Mean operative time was 75 min (range 45 to 130 min). Mean estimated blood loss was 35 mL (range 20 to 55 mL). Urine leakage occurred in one case and disappeared by drainage for 2 weeks. Mean follow-up period was 5 months (range 1 to 11 months), and no ureteric stricture or recurrent calculus were found. Conclusions:Laparoscopic ureterolithotomy via transperitoneal approach deserves clinical application in treatment of impacted upper ureteral calculi for the advantages of spacious space, clear anatomical landmarks and relatively simple manipulation.
