Laparoscopy And Oledochoscope Lithotripsy Jointly For Treatment Of26Cases With Ureteral And Renal Calculus

Background:Renal and ureteral calculus in Urology is the most common disease. In the past, we mainly take drugs or open surgery for treatment. From1980s, with the development and appliance of ESWL, URL, PCNL and LUL, minimally invasive techniques play a more and more impotent role in the treatment of ureteral stones, to significantly decrease the open surgery proportion. It’s worth to discuss and study that how to clear the ureteral stones and ipsilateral kidney stones only through one time of surgery under the premise of safety and small trauma. In this study, we try the surgery-laparoscopy and oledochoscope lithotripsy jointly, for the problem and it’s successful.Objective:Observing the treatment effect of LUL and oledochoscope jointly for26cases with renal and ureteral calculus, to provide clinical reference for treatment of upper or middle ureteral stones combined with the ipsilateral kidney stones.Methods:Urology Department, in Qilu Hospital of Shandong University, have operated the transabdominal approach LUL and oledochoscope lithotripsy jointly for26cases with the upper or middle ureteral stones and ipsilateral kidney stones from January2010to December2012. We collected the clinical data of these cases for analysis of the treatment effect, to provide clinical reference for treatment of upper or middle ureteral stones combined with the ipsilateral kidney stones.Results:1. We taked the transabdominal approach LUL and oledochoscope lithotripsy jointly for all of26cases, which had ureter stones combined with kidney stones at one lateral or the same with the other lateral. All of26cases were successful, with no transfusion of blood, no open surgery converted to, no kidney lost, no deaths in the perioperative period and1urinary fistula and infection.2. Of these,21patients underwent unilateral surgical treatment, and5patients underwent bilateral surgical treatment. The operating time in these26cases was80～340min, mean170min. And the volume of intraoperative blood was about15～50ml, mean28ml. The drainage time after surgery was7～37days, mean9days. Hospital stay time after surgery was8～42days, mean11days.7days after surgery there was no stones found by the B-ultrasound and the rate of clearance was100%. The time removal of double J tube was4～6weeks after surgery, except8weeks for one patient. After leaving hospital, hydronephrosis of26patients ameliorated in various degrees and there was no ureteral stenosis or deterioration of renal function.Conclusion:The transabdominal approach LUL and oledochoscope lithotripsy jointly is safe and effective for patients with the upper or middle ureteral stones and ipsilateral kidney stones, especially for calyceal stones, with high stone clearance rate, less blood loss, fewer complications, shorter recovery period and it’s minimally invasive. It have an advantage of clearing the ureter and kidney stones synchronously in an operation.