Clinical observation of different minimally invasive surgeries for the treatment of impacted upper ureteral calculi

Yuanhua Liu; Zhangyan Zhou; An Xia; Haitao Dai; Linjie Guo; Jiang Zheng

doi:10.12669/pjms.296.3910

Clinical observation of different minimally invasive surgeries for the treatment of impacted upper ureteral calculi

Pak J Med Sci. 2013 Nov;29(6):1358-62. doi: 10.12669/pjms.296.3910.

Authors

Yuanhua Liu¹, Zhangyan Zhou², An Xia³, Haitao Dai⁴, Linjie Guo⁵, Jiang Zheng⁶

Affiliations

¹ Yuanhua Liu, Department of Urinary Surgery, First Affiliated Hospital of Yangtze University, Jingzhou 434000, P. R. China.
² Zhangyan Zhou, Department of Urinary Surgery, First Affiliated Hospital of Yangtze University, Jingzhou 434000, P. R. China.
³ An Xia, Department of Urinary Surgery, First Affiliated Hospital of Yangtze University, Jingzhou 434000, P. R. China.
⁴ Haitao Dai, Department of Urinary Surgery, First Affiliated Hospital of Yangtze University, Jingzhou 434000, P. R. China.
⁵ Linjie Guo, Department of Urinary Surgery, First Affiliated Hospital of Yangtze University, Jingzhou 434000, P. R. China.
⁶ Jiang Zheng, Department of Urinary Surgery, First Affiliated Hospital of Yangtze University, Jingzhou 434000, P. R. China.

Abstract

Objective: To compare the clinical effects of three minimally invasive surgeries on the treatment of impacted upper ureteral calculi.

Methods: 135 patients with impacted upper ureteral calculi were selected and randomly divided into three groups (Group A-C) (n=45), which were treated with transurethral ureteroscopic lithotripsy, minimally invasive percutaneous nephrolithotomy, and retroperitoneal laparoscopic ureterolithotomy respectively. Relevant results of the three groups were compared.

Results: The surgery time of Group C was significantly longer than those of Group A and Group B (P < 0.05). The postoperative hospitalization time of Group B was significantly longer than those of Group A and Group C (P < 0.05). 37.78% (17/45) of Group A patients required extracorporeal shock wave lithotripsy, being significantly more than those in Group B (6.67%, 3/45) and Group C (0, 0/45) (P < 0.05). The postoperative calculus clearance rate of Group A (51.11%, 82.22%) was significantly lower than those of Group B (91.11%, 97.78%) and Group C (93.33%, 100%) (P < 0.05). The incidence rates of postoperative complications in Group A-C were 11.11% (5/45), 8.89% (4/45) and 6.67% (3/45) respectively without significant differences (P > 0.05).

Conclusion: The three surgical methods for impacted upper ureteral calculi should be selected according to practical conditions to improve therapeutic effects and to ensure safe surgery.

Keywords: Impacted upper ureteral calculus; Minimally invasive percutaneous nephrolithotomy; Retroperitoneal laparoscopic ureterolithotomy; Transurethral ureteroscopic lithotripsy.