Laparoscopic transperitoneal ureterolithotomy is an effective and safe method for > 15 mm impacted ureteral stones in elderly patients: single center 10-year experience
European Review for Medical and Pharmacological Sciences, cilt.26, sa.18, ss.6671-6677, 2022 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 26 Sayı: 18
- Basım Tarihi: 2022
- Doi Numarası: 10.26355/eurrev_202209_29768
- Dergi Adı: European Review for Medical and Pharmacological Sciences
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals
- Sayfa Sayıları: ss.6671-6677
- Anahtar Kelimeler: Laparoscopy, Ureterolithotomy, Elderly patient, Ureteral stones
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
OBJECTIVE: The aim of our study is to investigate the efficacy and safety of laparoscopic ureterolithotomy operation in elderly patients with large and impacted ureteral stones. PATIENTS AND METHODS: Between January 2011 and July 2021, 66 elderly patients with impacted, > 15 mm upper and middle ureteral stones underwent laparoscopic ureterolithotomy in our center. The data for all patients were evaluated retrospectively. RESULTS: The mean age of the patients was 65 ± 5.43 years. The mean stone size was 20.2 ± 2.5 mm. The mean operation time was 93.6 ± 13.2 minutes. Among patients, 16 (24.2%) had history of unsuccessful shock wave lithotripsy and 12 (18.1%) patients had history of ureterorenoscopy. Stone-free rate was 95.4% in all patients. Modified Clavien grade 1 complications were seen in 18 patients (27.2%), but no significant perioperative and postoperative complications were observed. Urinary extravasation lasting 5, 7 and 9 days was observed in 5 patients (7.5%) who were treated conservatively. The mean hospital stay was 3.4 ± 1.52 days. The patients were asymptomatic at the 6th week postop follow-up, and no stones were seen on direct X-ray and abdominal ultrasonography. Intravenous urography and non-contrast tomography (NCCT) taken 3 months later did not show any obstruction or stenosis in the ureter. CONCLUSIONS: Laparoscopic ureterolithotomy can be considered as the first treatment option for elderly patients with impacted and large ureteral stones, thanks to its high success and acceptable complication rates.