Retroperitoneal laparoscopic ureterolithotomy in comparison with ureteroscopic lithotripsy in the management of impacted upper ureteral stones larger than 12 mm

Shao, Yuan; Wang, Dawei; Zhang, Shen

doi:10.1007/s00345-015-1545-0

Cited by 34 publications

(41 citation statements)

References 21 publications

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“…Six RCT including 646 patients were selected for the analysis, 325 URS cases (50.3%) and 321 LU cases (49.7%) Table-1 (17–22). There were no differences regarding age (40.9 vs. 41.0 years, respectively), gender (61.2% vs. 62.5% male, respectively), stone size (13.6 vs. 18.2mm, respectively) and laterality of the procedure (49.7% vs. 52.4%, respectively) between the groups.…”

Section: Resultsmentioning

confidence: 99%

Semi-rigid ureteroscopic lithotripsy versus laparoscopic ureterolithotomy for large upper ureteral stones: a meta – analysis of randomized controlled trials

et al. 2016

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Introduction:To provide a systematic review and meta-analysis of randomized controlled trials (RCT) comparing semi-rigid ureteroscopic lithotripsy (URS) with laparoscopic ureterolithotomy (LU) for the treatment of the large proximal ureteral stone.Materials and methods:A systematic literature review was performed in June 2015 using the PubMed, Scopus, and Web of Science databases to identify relevant studies. Article selection proceeded according to the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria.Results:Six RCT including 646 patients were analyzed, 325 URS cases (50.3%) and 321 LU cases (49.7%). URS provided a significantly shorter operative time (weighted mean difference [WMD] = −31.26 min; 95%CI −46.88 to −15.64; p<0.0001) and length of hospital stay (WMD = −1.48 days; 95%CI −2.78 to −0.18; p=0.03) than LU. There were no significant differences in terms of overall complications (OR = 0.78; 95%CI 0.21-2.92; p=0.71) and major complications – Clavien ≥3 – (OR = 1.79; 95%CI 0.59-5.42; p=0.30). LU led to a significantly higher initial stone-free rate (OR = 8.65; 95%CI 4.18-17.91; p<0.00001) and final stone-free rate (OR = 6.41; 95%CI 2.24-18.32; p=0.0005) than URS. There was a significantly higher need for auxiliary procedures in URS cases (OR = 6.58; 95%CI 3.42-12.68; p<0.00001).Conclusions:Outcomes with LU for larger proximal ureteral calculi are favorable compared to semi-rigid URS and should be considered as a first-line alternative if flexible ureteroscopy is not available. Utilization of flexible ureteroscopy in conjunction with semi-rigid ureteroscopy may impact these outcomes, and deserves further systematic evaluation.

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Section: Resultsmentioning

confidence: 99%

Semi-rigid ureteroscopic lithotripsy versus laparoscopic ureterolithotomy for large upper ureteral stones: a meta – analysis of randomized controlled trials

et al. 2016

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“…Both procedures had the advantages and disadvantages in the management of upper ureteral stone. The retroperitoneal laparoscopic procedure was difficult and complex to perform during the urologist's learning-curve period [21,36] . The learning curve of the transperitoneal procedure was shorter than that of the retroperitoneal procedure, but it was significantly associated with pain, greater tramadol requirement, ileus, and longer hospital stay [37] .…”

Section: Discussionmentioning

confidence: 99%

“…However, in the current endourological era, the complication rate and morbidity of ureteroscopy have been significantly reduced [23,39] . Six included studies reported postoperative complications, which were classified according to the Clavien system [2,12,[18][19][20][21] . Most complications were of grades I and II.…”

Section: Discussionmentioning

confidence: 99%

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Ureteroscopic Lithotripsy versus Laparoscopic Ureterolithotomy or Percutaneous Nephrolithotomy in the Management of Large Proximal Ureteral Stones: A Systematic Review and Meta-Analysis

Wu¹,

Duan

Chen³

et al. 2017

Urol Int

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Objectives: To provide a systematic review and meta-analysis of studies comparing ureterolithotripsy (URS) with percutaneous nephrolithotripsy (PCNL) or laparoscopic ureterolithotomy (LU) techniques for the management of large proximal ureteral stones (diameter greater than 10 mm). Methods: A literature search was performed using PubMed, EMBASE, EBSCO, Web of Science, and Cochrane Library to identify suitable studies until November 2016. We used weighted mean difference to measure operative time and hospital stay, OR to measure stone free rate (SFR), and complication rate. Subgroup analyses were assessed for heterogeneity. Results: Fourteen publications strictly met our eligibility criteria of which 7 were randomized control studies (RCTs) and 7 non-RCTs. Meta-analysis of extractable data showed that LU and PCNL had higher SFR than URS. URS led to a similar hospital stay like that of LU. However, it had a shorter operative time and lower complication rate than LU. When we compared URS with PCNL, we found a shorter hospital stay in the URS group. However, there was no significant difference in terms of the operative time and complication rate between URS and PCNL. Conclusion: URS should be considered standard therapy for treating large proximal ureteral stones.

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“…In some publications, an impacted stone is defined as a stone that cannot be bypassed either by a wire or a catheter. 2,3 As understood from the definition, impacted stones that do not allow a catheter to pass to the kidneys are frequently encountered. The authors should explain more clearly and carefully whether retrograde catheterization was easily performed in the PCNL group, and if it was not possible, whether additional instrumentation was used and what approach was chosen.…”

mentioning

confidence: 99%

Treatment strategies for large impacted upper ureteral stones

Sancak

Akbaş

2016

CUAJ

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Retroperitoneal laparoscopic ureterolithotomy in comparison with ureteroscopic lithotripsy in the management of impacted upper ureteral stones larger than 12 mm

Abstract: RPLU could provide better stone clearance rate than semirigid URSL for upper ureteral impacted stones larger than 12 mm. It may also reduce the chance of surgical intervention for postoperative ureteral stricture.

Cited by 34 publications

References 21 publications

Semi-rigid ureteroscopic lithotripsy versus laparoscopic ureterolithotomy for large upper ureteral stones: a meta – analysis of randomized controlled trials

Semi-rigid ureteroscopic lithotripsy versus laparoscopic ureterolithotomy for large upper ureteral stones: a meta – analysis of randomized controlled trials

Ureteroscopic Lithotripsy versus Laparoscopic Ureterolithotomy or Percutaneous Nephrolithotomy in the Management of Large Proximal Ureteral Stones: A Systematic Review and Meta-Analysis

Treatment strategies for large impacted upper ureteral stones

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