Evaluation of the role of preoperative Double-J ureteral stenting in retroperitoneal laparoscopic pyelolithotomy

Chander, Jagdish; Dangi, Anuj Deep; Gupta, Nikhil; Vindal, Anubhav; Lal, Pawanindra; Ramteke, V. K.

doi:10.1007/s00464-009-0835-2

Cited by 10 publications

(5 citation statements)

References 10 publications

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“…On the contrary, 1 randomized controlled trial showed that preoperative ureter stenting significantly increased the rate of UTI after RLU. [ 29 ] When symptoms are not significant or pyuria is not detected because of the obstruction of impacted stone, UTI might be missed. Nevertheless, for incident concurrent UTI, on the basis of our previous experience and other reports, RLU is a safe option for obstructive upper ureteral stones, even for those without preoperative indwelling drainage tubes, [ 12 , 30 ] indicating the security of RLU.…”

Section: Discussionmentioning

confidence: 99%

Urgent laparoscopic ureterolithotomy for proximal ureter stones accompanied with obstructive pyelonephritis

Yang

Peng

et al. 2017

Medicine

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To evaluate the safety and efficacy of retroperitoneal laparoscopic ureterolithotomy (RLU) in the treatment of proximal ureteral stones accompanied with obstructive pyelonephritis without preoperative drainage.We retrospectively reviewed 21 cases of proximal ureteral stones with infected kidney undergoing RLU between July 2013 and September 2016. Stone-induced obstructive infected hydronephrosis was diagnosed using blood and urine tests and imaging modalities. Empirical effective broad spectrum antibiotic therapy was initiated immediately, and then urgent RLU was performed without preoperative drainage. During the surgical procedure, infected urine was also aspirated before stone was removed. Preoperative, intraoperative, and postoperative clinical data were collected.Operations were performed successfully without open conversion or blood transfusion. The mean operation time was 69.3 ± 12.33 minutes. For all the patients, the level of plasma procalcitonin decreased after RLU. The mean hospital stay duration was 6.4 ± 1.54 days. No septic shock or other severe complications occurred. By discharge, the body temperature and hemogram of each patient returned to normal. A 100% stone-free rate was achieved.Our study suggests that RLU is a potentially safe and effective method to treat proximal ureteral stones accompanied with obstructive pyelonephritis without any need of preoperative drainage.

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Section: Discussionmentioning

confidence: 99%

Urgent laparoscopic ureterolithotomy for proximal ureter stones accompanied with obstructive pyelonephritis

Yang

Peng

et al. 2017

Medicine

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“…Chander and colleagues reported that prestenting had no effect on the operation time of retroperitoneal laparoscopic pyelolithotomy. This result was not significant and probably not relevant for the results of ureterorenoscopic stone treatment [1]. …”

Section: Discussionmentioning

confidence: 99%

Impact of ureteral stenting prior to ureterorenoscopy on stone-free rates and complications

et al. 2011

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ObjectiveTo date, only few studies have evaluated the impact of ureteral stenting prior to ureterorenoscopy. This study is to clarify the role of preoperative ureteral stenting in the treatment for ureteral stones.MethodsWe retrospectively reviewed 550 ureterorenoscopies from 1998 to 2008. Patients were classified into two groups depending on whether they had a stent placed before URS. Baseline characteristics of patients and stone properties, stone-free rates, complications, and operation times were compared between both groups. Subanalysis was performed regarding stone localization. We retrospectively reviewed data from patient documentation, X-ray imagery, intravenous urography, and operation reports.ResultsBaseline characteristics of patients were similar in both groups. The majority of patients underwent stent placement before the ureteroscopic stone treatment (88.4%). The mean operation time in the prestented group was longer (43.3 vs. 38.4 min). Stone-free rate of patients with stent was 72.2%, compared to 59.4% without preoperative stenting. The rate of minor complications was 4.7% with stent versus 9.4% without stent, major complications 0.6% versus 1.6%, respectively. Patients with distal ureter stones had similar stone-free rates regardless of a stent placement (90.1% with stent vs. 87.6% without), and no difference in complication rates was observed (3.5% with stent vs. 3.1% without), respectively.ConclusionsStent placement prior to ureteroscopic stone treatment in distal ureter is not reasonable and does not considerably improve stone-free rates.

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“…2 Laparoscopic pyelolithotomy (retroperitoneal or transperitoneal) has been proposed as a minimally invasive alternative to open surgery, with high stone clearance rates (range, 75-100%). [5][6][7] According to a retrospective study comparing laparoscopic retroperitoneal pyelolithotomy (n ϭ 16) with PCNL (n ϭ 12), 8 PCNL caused less morbidity and was easier to perform, whereas laparoscopic pyelolithotomy should be reserved for patients who need adjunctive procedures. A similar retrospective study comparing transperitoneal laparoscopic pyelolithotomy and PCNL also showed that the laparoscopic approach is safe but technically challenging and time consuming.…”

Section: Discussionmentioning

confidence: 99%

Combined Robotic Pyelolithotomy and Laser Lithotripsy for Staghorn Calculi

Ploumidis

Philippou

Skolarikos

et al. 2014

CRSLS

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Introduction: Robotic-assisted pyelolithotomy (RAPL) has recently immerged as an alternative approach for the management of complex kidney stones. RAPL combines the benefits of minimally invasive surgery with the high stone clearance rates achieved by open lithotomy. Case Description:We describe the successful combination of RAPL and Holmium laser lithotripsy for the management of a staghorn calculus in a 57-year-old man who had previously undergone a failed percutaneous nephrolithotomy. Discussion and Conclusion:The 500-m Holmium laser fiber was navigated by the console surgeon, who also controlled the laser foot pedal, thus maximizing surgeon control of the procedure. The combination of robotically assisted laparoscopic surgery and Holmium laser lithotripsy is a feasible and safe management option for achieving clearance of complex renal stones. To the best of our knowledge, this appears to be the first reported case, confirming the safety and efficacy of this combined technique.

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Evaluation of the role of preoperative Double-J ureteral stenting in retroperitoneal laparoscopic pyelolithotomy

Cited by 10 publications

References 10 publications

Urgent laparoscopic ureterolithotomy for proximal ureter stones accompanied with obstructive pyelonephritis

Urgent laparoscopic ureterolithotomy for proximal ureter stones accompanied with obstructive pyelonephritis

Impact of ureteral stenting prior to ureterorenoscopy on stone-free rates and complications

Combined Robotic Pyelolithotomy and Laser Lithotripsy for Staghorn Calculi

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