Retroperitoneoscopy for treatment of renal and ureteral stones
OBJECTIVE: To assess the efficacy of retroperitoneoscopy for treating stones in the renal pelvis and proximal ureter. MATERIALS AND METHODS: In the period from August 2003 to August 2004, 35 retroperitoneoscopies for treatment of urinary stones were performed on 34 patients. Fifteen patients (42%) h...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
2005-04-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382005000200004 |
| _version_ | 1828523686722797568 |
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| author | Rodrigo S. Soares Pedro Romanelli Marcos A. Sandoval Marcelo M. Salim Jose E. Tavora David L. Abelha Jr |
| author_facet | Rodrigo S. Soares Pedro Romanelli Marcos A. Sandoval Marcelo M. Salim Jose E. Tavora David L. Abelha Jr |
| author_sort | Rodrigo S. Soares |
| collection | DOAJ |
| description | OBJECTIVE: To assess the efficacy of retroperitoneoscopy for treating stones in the renal pelvis and proximal ureter. MATERIALS AND METHODS: In the period from August 2003 to August 2004, 35 retroperitoneoscopies for treatment of urinary stones were performed on 34 patients. Fifteen patients (42%) had stones in the renal pelvis, and in 2 cases, there were associated stones in the upper caliceal group. Twenty patients (58%) had ureteral stones, all of them located above the iliac vessel. Twenty-five patients (71%) had previously undergone at least one session of extracorporeal lithotripsy and 8 patients (26%) also underwent ureteroscopy to attempt to remove the stone. Eight patients underwent retroperitoneoscopy as a primary procedure. Stone size ranged from 0.5 to 6 cm with a mean of 2.1 cm. RESULTS: Retroperitoneoscopy was performed by lumbar approach with initial access conducted by open technique and creation of space by digital dissection. We used a 10-mm Hasson trocar for the optics, and 2 or 3 additional working ports placed under visualization. Following identification, the urinary tract was opened with a laparoscopic scalpel and the stone was removed intact. The urinary tract was closed with absorbable 4-0 suture and a Penrose drain was left in the retroperitoneum. In 17 patients (49%), a double-J stent was maintained postoperatively. Surgical time ranged from 60 to 260 minutes with a mean of 140 minutes. The mean hospital stay was 3 days (1-10 days). The mean length of retroperitoneal urinary drainage was 3 days (1-10 days). There were minor complications in 6 (17.6%) patients and 1 case of conversion due to technical difficulty. Thirty-three patients (94%) became stone free. CONCLUSION: Retroperitoneoscopy is an effective, low-morbidity alternative for treatment of urinary stones. |
| first_indexed | 2024-12-11T20:32:15Z |
| format | Article |
| id | doaj.art-729a9ce68cb0466d8370726180efcb5b |
| institution | Directory Open Access Journal |
| issn | 1677-5538 1677-6119 |
| language | English |
| last_indexed | 2024-12-11T20:32:15Z |
| publishDate | 2005-04-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-729a9ce68cb0466d8370726180efcb5b2022-12-22T00:51:46ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-55381677-61192005-04-0131211111610.1590/S1677-55382005000200004Retroperitoneoscopy for treatment of renal and ureteral stonesRodrigo S. SoaresPedro RomanelliMarcos A. SandovalMarcelo M. SalimJose E. TavoraDavid L. Abelha JrOBJECTIVE: To assess the efficacy of retroperitoneoscopy for treating stones in the renal pelvis and proximal ureter. MATERIALS AND METHODS: In the period from August 2003 to August 2004, 35 retroperitoneoscopies for treatment of urinary stones were performed on 34 patients. Fifteen patients (42%) had stones in the renal pelvis, and in 2 cases, there were associated stones in the upper caliceal group. Twenty patients (58%) had ureteral stones, all of them located above the iliac vessel. Twenty-five patients (71%) had previously undergone at least one session of extracorporeal lithotripsy and 8 patients (26%) also underwent ureteroscopy to attempt to remove the stone. Eight patients underwent retroperitoneoscopy as a primary procedure. Stone size ranged from 0.5 to 6 cm with a mean of 2.1 cm. RESULTS: Retroperitoneoscopy was performed by lumbar approach with initial access conducted by open technique and creation of space by digital dissection. We used a 10-mm Hasson trocar for the optics, and 2 or 3 additional working ports placed under visualization. Following identification, the urinary tract was opened with a laparoscopic scalpel and the stone was removed intact. The urinary tract was closed with absorbable 4-0 suture and a Penrose drain was left in the retroperitoneum. In 17 patients (49%), a double-J stent was maintained postoperatively. Surgical time ranged from 60 to 260 minutes with a mean of 140 minutes. The mean hospital stay was 3 days (1-10 days). The mean length of retroperitoneal urinary drainage was 3 days (1-10 days). There were minor complications in 6 (17.6%) patients and 1 case of conversion due to technical difficulty. Thirty-three patients (94%) became stone free. CONCLUSION: Retroperitoneoscopy is an effective, low-morbidity alternative for treatment of urinary stones.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382005000200004kidney calculiureteral calculisurgerylaparoscopyretroperitoneal space |
| spellingShingle | Rodrigo S. Soares Pedro Romanelli Marcos A. Sandoval Marcelo M. Salim Jose E. Tavora David L. Abelha Jr Retroperitoneoscopy for treatment of renal and ureteral stones International Brazilian Journal of Urology kidney calculi ureteral calculi surgery laparoscopy retroperitoneal space |
| title | Retroperitoneoscopy for treatment of renal and ureteral stones |
| title_full | Retroperitoneoscopy for treatment of renal and ureteral stones |
| title_fullStr | Retroperitoneoscopy for treatment of renal and ureteral stones |
| title_full_unstemmed | Retroperitoneoscopy for treatment of renal and ureteral stones |
| title_short | Retroperitoneoscopy for treatment of renal and ureteral stones |
| title_sort | retroperitoneoscopy for treatment of renal and ureteral stones |
| topic | kidney calculi ureteral calculi surgery laparoscopy retroperitoneal space |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382005000200004 |
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