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Urolitiasis |
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| Portal de información sobre litiasis del aparato urinario | ||
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| Urolitiasis |
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Cirugía laparoscópica de la litiasis urinaria
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Manejo laparoscópico de la urolitiasis Christian Saussine WebSurg (Requiere registro gratuito) |
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"Urolithiasis"[Majr] AND "Laparoscopy"[Majr]:
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Experience and learning curve of retroperitoneal laparoscopic ureterolithotomy for upper ureteral calculi. J Endourol. 2009 Nov;23(11):1867-70 Authors: Fan T, Xian P, Yang L, Liu Y, Wei Q, Li H PURPOSE: To summarize our experience and evaluate the learning curve of retroperitoneal laparoscopic ureterolithotomy of the upper ureter. PATIENTS AND METHODS: Between May 2004 and May 2007, 40 patients underwent retroperitoneal laparoscopic ureterolithotomy of the upper ureter. We divided the first and last 20 patients into group I and group II. There was no statistical difference in stone size between groups. Operative time and complications were measured as a basis for the assessment of the learning curve. RESULTS: In group I, the complication rate was 15% (3/20), including two patients whose procedure was converted to open surgery because of intraoperative bleeding, and one patient who experienced urine leakage because of a displaced Double-J ureteral stent. In group II, no postoperative complications occurred, while the mean operative time was significantly shorter compared with the earlier operations (65 vs 120 min). CONCLUSION: Retroperitoneal laparoscopic ureterolithotomy is safe and effective for large or impacted stones of the upper ureter. It is associated with a short learning curve in the setting of an active laparoscopic practice for selected patients. PMID: 19811058 [PubMed - indexed for MEDLINE] Laparoscopic simultaneous treatment of peripelvic renal cysts and stones: case series. J Endourol. 2009 Nov;23(11):1851-6 Authors: Micali S, Pini G, Sighinolfi MC, De Stefani S, Annino F, Bianchi G INTRODUCTION: Renal multiple peripelvic cysts are often symptomatic. Obstruction of renal hilum and the collecting system leads to hydronephrosis and could promote formation of stones. Managing both entities at the same time needs a new approach to minimize complications and improve success rates. We report for the first time five cases of symptomatic multiple peripelvic cysts and concomitant kidney stones treated by a laparoscopic approach. PATIENTS AND METHODS: Between 2003 and 2007 three men and two women, with a median age of 60 years with peripelvic renal cyst and synchronous kidney stones underwent a laparoscopic ablation of cysts, concomitant pyelolithotomy, and stone removal with a flexible auxiliary cystoscope. Mean cyst size was 45 mm (range 15-70 mm). Mean stone size was 25 mm (range 10-33 mm). RESULTS: The mean operative time was 173 minutes (range 150-235 minutes). There were neither intraoperative complications nor conversions to open surgery. Mean blood lost was less than 100 mL, and mean hospital stay was 3.2 days (range 3-5 days). After removal of ureteral catheter, patients were asymptomatic and without signs of hydronephrosis. Computed tomography after 6 months showed clearance of all cysts and stones without sign of recurrence. DISCUSSION: Laparoscopic management of urolithiasis should be an alternative choice of treatment in some particular and selected indication. Concomitant symptomatic peripelvic cysts and kidney stones could justify simultaneous laparoscopic management. The procedure is technically challenging but safe and effective, and it avoids a staged treatment. PMID: 19619068 [PubMed - indexed for MEDLINE] |
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