Prospective Randomized Study of Treatment of Large Proximal Ureteral Stones: Extracorporeal Shock Wave Lithotripsy Versus Ureterolithotripsy Versus Laparoscopy

Neto, Antônio Corrêa Lopes; Korkes, Fernando; Silva, Jarques Lúcio; Amarante, Rodrigo Dal Moro; Mattos, Mário Henrique Elias de; Tobias-Machado, Marcos; Pompeo, Antônio Carlos Lima

doi:10.1016/j.juro.2011.09.054

Cited by 66 publications

(38 citation statements)

References 16 publications

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“…Treatment of large proximal ureteral stones is one of the most controversial issues of endourology today [1,2,3,4]. Current treatment options used in the treatment of those stones include shock wave lithotripsy (SWL), semirigid ureteroscopy (URS), flexible ureteroscopy (F-URS), laparoscopic ureterolithotomy, and open surgery.…”

Section: Introductionmentioning

confidence: 99%

Flexible Ureteroscopy versus Retroperitoneal Laparoscopic Ureterolithotomy for the Treatment of Proximal Ureteral Stones >15 mm: A Single Surgeon Experience

et al. 2015

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Objective: To compare safety and effectiveness of flexible ureteroscopy (F-URS) and laparoscopic retroperitoneal ureterolithotomy (L-RU) in treatment of proximal ureteral stones larger than 15 mm. Materials and Methods: This study included 103 patients treated with L-RU (Group I), and 80 patients treated with F-URS (Group II) due to proximal ureteral stones larger than 1.5 cm, in a single center. Patients' characteristics and procedure-related parameters including success rate, operation time, hospital stay, postoperative visual analogue scale (VAS) scores, auxiliary procedures, and complications were compared between Groups I and II. Results: It was seen that both methods were effective in the treatment of large ureteral stones; however, R-LU provided a higher stone-free rate (100 vs. 87.5%), a lower complication rate (10.6 vs. 23.7%), and a shorter operation time (65.4 vs. 75.1 min). On the other hand, patients treated with F-URS had less postoperative pain, a shorter hospital stay, a faster return to daily activities. Conclusions: For treatment of large proximal ureteral stones, L-RU provides significantly higher success and lower retreatment rate compared with F-URS. Our results also indicate that R-LU, which has been regarded as an invasive procedure is not as invasive as it is thought to be, and it must be kept in mind that F-URS may cause complications despite its noninvasive nature.

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Section: Introductionmentioning

confidence: 99%

Flexible Ureteroscopy versus Retroperitoneal Laparoscopic Ureterolithotomy for the Treatment of Proximal Ureteral Stones >15 mm: A Single Surgeon Experience

et al. 2015

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“…The mean hospitalization was 2 days, similar to the literature. 17 The mean operation time was 78 minutes for the first 30 cases and 43 minutes for the remaining cases. With minimum hemorrhage and morbidity rates, a single-session treatment is advantageous for patients.…”

Section: Discussionmentioning

confidence: 97%

“…The complication rate (8%) was parallel to the findings in literature. 13,14,17 Flexible ureteroscopy is one of the highly popular natural orifice surgeries. With its relatively lower morbidity and the use of natural orifices, this technique is considered first-line by patients and surgeons.…”

Section: Discussionmentioning

confidence: 99%

The comparison of laparoscopy, shock wave lithotripsy and retrograde intrarenal surgery for large proximal ureteral stones

Öztürk

Şener

Göktuğ

et al. 2013

CUAJ

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Introduction: In this study we compare the success rates and complication rates of shock wave lithotripsy (SWL), laparoscopic, and ureteroscopic approaches for large (between 1 and 2 cm) proximal ureteral stones. Methods: In total, 151 patients with ureteral stones between 1 and 2 cm in diameter were randomized into 3 groups (52 SWL, 51 laparoscopy and 48 retrograde intrarenal surgery [RIRS]). The groups were compared for stone size, success rates, and complication rates using the modified Clavien grading system. Results: Stone burden of the groups were similar (p = 0.36). The success rates were 96%, 81% and 79%, respectively in the laparoscopy, SWL, and ureteroscopy groups. The success rate in laparoscopy group was significantly higher (p < 0.05). When these groups were compared for complication rates, RIRS seemed to be the group with the lowest complication rates (4.11%) (p < 0.05). SWL and laparoscopy seem to have similar rates of complication (7.06% and 7.86%, respectively, p = 0.12). Interpretation: To our knowledge, this is the first study to compare the results of laparoscopy, SWL and RIRS in ureteral stones. Our results showed that in management of patients with upper ureteral stones between 1 and 2 cm, laparoscopy is the most successful method based on its stone-free rates and acceptable complication rates. However, the limitations of our study are lack of hospital stay and cost-effectiveness data. Also, studies conducted on larger populations should support our findings. When a less invasive method is the only choice, SWL and flexible ureterorenoscopy methods have similar success rates. RIRS, however, has a lower complication rate than the other approaches. IntroductionUpper ureteral stones, which are hard to treat, are frequently encountered in daily practice. For treatment, the most effective and the safest approach should be chosen. Upper ureteral stones can be managed by various approaches. There is no gold standard treatment for stones between 1 and 2 cm. Even though some researchers recommend extracorporeal shock wave lithotripsy (SWL) as first-line treatment, 1 it has a 40% success rate in larger proximal ureteral calculi.2 With the common use of flexible devices in urology, ureteroscopy has gained popularity in the treatment of upper ureteral stones. For stones larger than 1 cm and fully obstructing the passage in the ureter, open or laparoscopic surgery may be an option with success rates up to 100%.1 In recent years, some authors have published their data on the laparoscopic approach and have recommended its use for its high success and low complication rates. 3This study compares the success and complication rates of SWL and laparoscopic and ureteroscopic approaches for proximal ureteral calculi between 1 and 2 cm. MethodsAfter Institutional Review Board approval, we enrolled 150 patients who had ureteral stones between 1 and 2 cm in the study; they were randomized into 3 groups by an online randomization program (52 for SWL, 51 for laparoscopy, and 48 for retrograde intrarenal surge...

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“…Lopes et al reported that SWL has lower stone-free rates and a higher number of procedures for large proximal and mid-ureter stones [6]. Although URS is the first option for ureteral stones, its success rate is decreased in large mid- or upper-ureter stones [7].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ureteroscopic Laser Lithotripsy with Laparoscopic Ureterolithotomy for Large Proximal and Mid-Ureter Stones

Kaygısız¹,

Çoşkun²,

Kılıçarslan³

et al. 2015

Urol Int

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Objectives: To compare the effectiveness and complications of ureteroscopic laser lithotripsy with laparoscopic ureter laparoscopic ureterolithotomy in mid- or proximal portion of large ureteral stones. Material and Methods: We reviewed patients with large (>15 mm) ureteral stone and those who underwent ureteroscopic laser lithotripsy (URS group) or laparoscopic ureterolithotomy (LU group). The first attempt was considered successful in patients who had residual fragments smaller than 2 mm and no conversion of the primary procedure to another. Results: Sixty patients (URS group 29, LU group 31) met inclusion criteria. FURS was used as an adjunctive procedure in one patient for URS group and in two patients for LU group in the same season. LU had a higher success rate and the first-day stone-free rate when compared with URS. Number of procedures was also significantly higher in URS group. There was no difference in stone-free rates at the first and third months, and length of hospitalization and operation were higher in the LU group. Only two patients in the LU group and one patient in the URS group had major complications. Conclusions: Laparoscopy is an effective option of large proximal and mid-ureter stone treatment; however, URS provides similar stone-free rates at three months as a minimal invasive procedure.

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Prospective Randomized Study of Treatment of Large Proximal Ureteral Stones: Extracorporeal Shock Wave Lithotripsy Versus Ureterolithotripsy Versus Laparoscopy

Cited by 66 publications

References 16 publications

Flexible Ureteroscopy versus Retroperitoneal Laparoscopic Ureterolithotomy for the Treatment of Proximal Ureteral Stones >15 mm: A Single Surgeon Experience

Flexible Ureteroscopy versus Retroperitoneal Laparoscopic Ureterolithotomy for the Treatment of Proximal Ureteral Stones >15 mm: A Single Surgeon Experience

The comparison of laparoscopy, shock wave lithotripsy and retrograde intrarenal surgery for large proximal ureteral stones

Comparison of Ureteroscopic Laser Lithotripsy with Laparoscopic Ureterolithotomy for Large Proximal and Mid-Ureter Stones

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