The role of laparoscopic surgery in the management of urinary lithiasis in the era of endourology in Mexico
DOI:
https://doi.org/10.48193/zc2x9531Keywords:
Pyelolithotomy, ureterolithotomy, laparoscopy, lithiasisAbstract
Objective: The aim of the present study was to describe the results of a case series of laparoscopic pyelolithotomies and ureterolithotomies performed at the Hospital General de México and demonstrate that the laparoscopic management still has a place among the therapeutic options in our country.
Material and methods: Retrospective analysis on patients that underwent laparoscopic pyelolithotomy or laparoscopic ureterolithotomy, within the time frame of 2013 and 2022. Intraoperative variables of blood loss, surgery duration, and complications; and the postoperative variables of hospital stay, time to double-J stent removal, and complications were analyzed.
Results: 46 underwent laparoscopic pyelolithotomy and 29 underwent laparoscopic ureterolithotomy. Mean patient age was 45 years. Forty-three of the procedures were right-sided, 31 were left-sided, and there was one case of ectopic pelvic kidney. The pyelolithotomy results were: stone size of 24x20mm (8.8-60 x 5-60), 1034 HU, S.T.O.N.E. score of 6, surgery duration of 124 min, blood loss of 72ml, and hospital stay of 2.3 days. The ureterolithotomy results were: stone size of 22x11mm (10-80mm x 7.8-20), 980 HU, surgery duration of 101min, blood loss of 31ml, and hospital stay of 2.4 days. There were 3 intraoperative complications and 4 postoperative complications.
Conclusión: Laparoscopic surgery can be a feasible and reproducible alternative to endourologic management, with good results, in large volume (>20mm) single stones.
References
Rukin NJ, Siddiqui ZA, Chedgy ECP, Somani BK. Trends in Upper Tract Stone Disease in England: Evidence from the Hospital Episodes Statistics Database. Urologia Internationalis. 2017;98(4): 391–396. https://doi.org/10.1159/000449510.
Curhan GC. Epidemiology of Stone Disease. The Urologic clinics of North America. 2007;34(3): 287–293. https://doi.org/10.1016/j.ucl.2007.04.003.
Ortegón-Gallareta R, Aguilar-Moreno J, Álvarez-Baeza A, Méndez-Domínguez N, Pech-Cervantes PI. Perfil epidemiológico de las hospitalizaciones por urolitiasis en el Estado de Yucatán, México. Revista Mexicana de Urología. 2019;79(5): 1–11. https://doi.org/10.48193/revistamexicanadeurologa.v79i5.517.
Shah J, Whitfield HN. Urolithiasis through the ages. BJU international. 2002;89(8): 801–810. https://doi.org/10.1046/j.1464-410x.2002.02769.x.
Jones P, Elmussareh M, Aboumarzouk OM, Mucksavage P, Somani BK. Role of Minimally Invasive (Micro and Ultra-mini) PCNL for Adult Urinary Stone Disease in the Modern Era: Evidence from a Systematic Review. Current Urology Reports. 2018;19(4): 27. https://doi.org/10.1007/s11934-018-0764-5.
Ng ACF, Wong MYC, Isotani S, Practical Management of Urinary Stone. Singapore: Springer; 2021. https://doi.org/10.1007/978-981-16-4193-0.
European Association of Urology. EAU Guidelines on Urolithiasis. 2022 https://uroweb.org/guidelines/urolithiasis
American Urological Association. Kidney Stones: Surgical Management Guideline. 2022
Doizi S, Traxer O. Flexible ureteroscopy: technique, tips and tricks. Urolithiasis. 2018;46(1): 47–58. https://doi.org/10.1007/s00240-017-1030-x
Proietti S, Rodríguez-Socarrás ME, Eisner B, De Coninck V, Sofer M, Saitta G, et al. Supine percutaneous nephrolithotomy: tips and tricks. Translational Andrology and Urology. 2019;8(Suppl 4): S381–S388. https://doi.org/10.21037/tau.2019.07.09.
Bayne DB, Chi TL. Assessing Cost-Effectiveness of New Technologies in Stone Management. The Urologic Clinics of North America. 2019;46(2): 303–313. https://doi.org/10.1016/j.ucl.2018.12.011.
Yadav R, Kumar R, Hemal AK. Laparoscopy in the management of stone disease of urinary tract. Journal of Minimal Access Surgery. 2005;1(4): 173–180. https://doi.org/10.4103/0972-9941.19264.
Hejj R, McNulty M, Calleary JG, Hejj R, McNulty M, Calleary JG. Urology: The Home of Endoscopy. In: Advances in Endoscopic Surgery. IntechOpen; 2011. https://doi.org/10.5772/24729.
Al-Awadi K, Kehinde EO, Al-Hunayan A, Al-Khayat A. Iatrogenic ureteric injuries: incidence, aetiological factors and the effect of early management on subsequent outcome. International Urology and Nephrology. 2005;37(2): 235–241. https://doi.org/10.1007/s11255-004-7970-4
de la Rosette J, Denstedt J, Geavlete P, Keeley F, Matsuda T, Pearle M, et al. The clinical research office of the endourological society ureteroscopy global study: indications, complications, and outcomes in 11,885 patients. Journal of Endourology. 2014;28(2): 131–139. https://doi.org/10.1089/end.2013.0436.
de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, et al. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. Journal of Endourology. 2011;25(1): 11–17. https://doi.org/10.1089/end.2010.0424.
Simforoosh N, Aminsharifi A. Laparoscopic management in stone disease. Current Opinion in Urology. 2013;23(2): 169–174. https://doi.org/10.1097/MOU.0b013e32835d307f.
Hassan Y, Rather AA, Bashir A, Wani IA, Rasool H. Comparative Study of Laparoscopic and Open Pyelolithotomy in the Management of Large Renal Pelvic Stones. Ibnosina Journal of Medicine and Biomedical Sciences. 2022;14: 022–027. https://doi.org/10.1055/s-0042-1749143.
Hamid CA, Ankur S, Sathish R. Laparoscopic management of urinary tract calculi: uncommon but effective alternative to open surgery in certain situations. International Archives of Integrated Medicine. 2019;6(5)
Bai Y, Tang Y, Deng L, Wang X, Yang Y, Wang J, et al. Management of large renal stones: laparoscopic pyelolithotomy versus percutaneous nephrolithotomy. BMC urology. 2017;17(1): 75. https://doi.org/10.1186/s12894-017-0266-7
Kusuma Duarsa GW, Wisnu Tirtayasa PM, Pramana IBP, Yudiana IW, Santosa KB, Oka AAG. Meta-Analysis of Laparoscopic Pyelolithotomy versus Percutaneous Nephrolithotomy as a Treatment of Large Kidney Stones. Open Access Macedonian Journal of Medical Sciences. 2022;10(F): 113–121. https://doi.org/10.3889/oamjms.2022.8122.
Wu T, Duan X, Chen S, Yang X, Tang T, Cui S. Ureteroscopic Lithotripsy versus Laparoscopic Ureterolithotomy or Percutaneous Nephrolithotomy in the Management of Large Proximal Ureteral Stones: A Systematic Review and Meta-Analysis. Urologia Internationalis. 2017;99(3): 308–319. https://doi.org/10.1159/000471773.
Choi JD, Seo SI, Kwon J, Kim BS. Laparoscopic Ureterolithotomy vs Ureteroscopic Lithotripsy for Large Ureteral Stones. JSLS : Journal of the Society of Laparoendoscopic Surgeons. 2019;23(2): e2019.00008. https://doi.org/10.4293/JSLS.2019.00008
Güler Y, Erbin A. Comparative evaluation of retrograde intrarenal surgery, antegrade ureterorenoscopy and laparoscopic ureterolithotomy in the treatment of impacted proximal ureteral stones larger than 1.5 cm. Central European Journal of Urology. 2021;74(1): 57–63. https://doi.org/10.5173/ceju.2021.0174.R1.
Lai S, Jiao B, Diao T, Seery S, Hu M, Wang M, et al. Optimal management of large proximal ureteral stones (>10 mm): A systematic review and meta-analysis of 12 randomized controlled trials. International Journal of Surgery. 2020;80: 205–217. https://doi.org/10.1016/j.ijsu.2020.06.025.
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