Comparison of laparoscopic ureterolithotomy, retrograde flexible ureteroscopy, and mini-percutaneous antegrade flexible ureteroscopic lithotripsy for treating large (≥ 15 mm) impacted proximal ureteric stones: a prospective randomized trial.

IF 2 2区医学 Q2 UROLOGY & NEPHROLOGY Urolithiasis Pub Date : 2024-07-22 DOI:10.1007/s00240-024-01602-2

Ahmed Zoeir, Talaat Zaghloul, Tarek Gameel, Ayman Mousa, Hasan El Tatawy, Maged Ragab, Mohammed Abo-El Enein, Hussein Mamdoh

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Abstract

The purpose of this study is to compare the outcomes of transperitoneal laparoscopic ureterolithotomy (TPLU), retrograde flexible ureteroscopy (R-fURS), and mini-percutaneous antegrade flexible ureteroscopy (A-fURS) for treating large (≥ 15 mm) impacted proximal ureteral stones. A total of 105 adult patients were randomized into 3 equal groups: group A (35) patients underwent TPLU, group B (35) patients underwent R-fURS, and group C (35) patients underwent A-fURS. The initial stone-free rate was 100%, 68.6%, and 80% in groups A, B, and C, respectively. The mean operative time (OT) was (85.0 ± 7.57 min) in group A, (61.0 ± 8.21 min) in group B, and (89.57 ± 15.12 min) in group C. The three groups were comparable concerning the overall complications. R-fURS is a less invasive modality for treating such stones; however, it is associated with a lower SFR and a higher rate of auxiliary procedures. Both TPLU and miniperc A-fURS are effective and valuable alternatives for treating large impacted proximal ureteric stones.

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比较腹腔镜输尿管碎石术、逆行柔性输尿管镜检查和迷你经皮前向柔性输尿管镜碎石术治疗大块（≥ 15 毫米）冲击性输尿管近端结石：一项前瞻性随机试验。

本研究旨在比较经腹腔镜输尿管碎石术（TPLU）、逆行柔性输尿管镜检查（R-fURS）和迷你经皮前行柔性输尿管镜检查（A-fURS）治疗大块（≥ 15 mm）输尿管近端结石的疗效。105名成年患者被随机分为3组：A组（35人）接受TPLU，B组（35人）接受R-fURS，C组（35人）接受A-fURS。A 组、B 组和 C 组的初始无结石率分别为 100%、68.6% 和 80%。A 组的平均手术时间（OT）为（85.0 ± 7.57 分钟），B 组为（61.0 ± 8.21 分钟），C 组为（89.57 ± 15.12 分钟）。R-fURS是治疗此类结石的一种创伤较小的方法，但其SFR较低，辅助手术率较高。TPLU和miniperc A-fURS都是治疗大块冲击性近端输尿管结石的有效且有价值的替代方法。

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来源期刊

Urolithiasis UROLOGY & NEPHROLOGY-

CiteScore

4.50

自引率

6.50%

发文量

期刊介绍： Official Journal of the International Urolithiasis Society The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field. Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.