Estudio prospectivo que compara laparoscopia y cirugía abierta para el tratamiento de cálculos ureterales impactados

Translated title of the contribution: Prospective trial comparing laparoscopy and open surgery for management of impacted ureteral stones

Gilberto L. Almeida, Flavio L. Heldwein, Tulio M. Graziotin, Caio S. Schmitt, Cláudio Telöken

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Introduction and objectives: To investigate two ureterolithotomy approaches for treatment of large and impacted upper ureteral stones, we prospectively evaluated the perioperative features of consecutive patients submitted to ureterolithotomy following failure of endourological treatment. Methods: Of the 110 patients included in the study, 34 underwent laparoscopic ureterolithotomy. Patients were divided into three ureterolithotomy subgroups (group A, 76 open procedures; group B, 16 transperitoneoscopies and group C, 19 retroperitoneoscopies). All procedures were performed into a urology residency program. Results: The patients' age, sex, ASA classification and stones characteristics showed no significant difference between the groups. Overall, complication rates and the operation times recorded were similar. One patient had bilateral stones and both sides were managed in a single transperitoneoscopy procedure. Three retroperitoneoscopies were converted to an open surgery due technical difficulties. A prolonged urinary leakage occurred in 3/35 cases (8.5%) where 2 patients were treated by placing a ureteral catheter. Both laparoscopic groups have significantly less analgesia requirements and shorter hospitalization (p <0.001 and p = 0.003, respectively). All patients were stone-free in the follow-up 1-month visit. Conclusions: To our knowledge, this is the first prospective comparison of laparoscopic and open ureterolithotomy in a laparoscopic training scenario. Even though these procedures were performed by limited laparoscopic experience urologists, laparoscopy offered significant advantages over traditional open ureterolithotomy, resulting in improved analgesia, shorter hospital stays and similar complication rates.

Original languageSpanish
Pages (from-to)1108-1114
Number of pages7
JournalActas urologicas españolas
Volume33
Issue number10
DOIs
Publication statusPublished - Nov 2009

Fingerprint

Laparoscopy
Analgesia
Urinary Catheters
Urology
Internship and Residency
Treatment Failure
Length of Stay
Hospitalization

Keywords

  • Cálculos ureterales
  • Intervenciones quirúrgicas mínimamente
  • Invasivas
  • Laparoscopia
  • Laparoscopy
  • Minimally invasive surgical procedures
  • Obstrucción ureteral
  • Ureteral calculi
  • Ureteral obstruction

ASJC Scopus subject areas

  • Urology

Cite this

Estudio prospectivo que compara laparoscopia y cirugía abierta para el tratamiento de cálculos ureterales impactados. / Almeida, Gilberto L.; Heldwein, Flavio L.; Graziotin, Tulio M.; Schmitt, Caio S.; Telöken, Cláudio.

In: Actas urologicas españolas, Vol. 33, No. 10, 11.2009, p. 1108-1114.

Research output: Contribution to journalArticle

Almeida, Gilberto L. ; Heldwein, Flavio L. ; Graziotin, Tulio M. ; Schmitt, Caio S. ; Telöken, Cláudio. / Estudio prospectivo que compara laparoscopia y cirugía abierta para el tratamiento de cálculos ureterales impactados. In: Actas urologicas españolas. 2009 ; Vol. 33, No. 10. pp. 1108-1114.
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abstract = "Introduction and objectives: To investigate two ureterolithotomy approaches for treatment of large and impacted upper ureteral stones, we prospectively evaluated the perioperative features of consecutive patients submitted to ureterolithotomy following failure of endourological treatment. Methods: Of the 110 patients included in the study, 34 underwent laparoscopic ureterolithotomy. Patients were divided into three ureterolithotomy subgroups (group A, 76 open procedures; group B, 16 transperitoneoscopies and group C, 19 retroperitoneoscopies). All procedures were performed into a urology residency program. Results: The patients' age, sex, ASA classification and stones characteristics showed no significant difference between the groups. Overall, complication rates and the operation times recorded were similar. One patient had bilateral stones and both sides were managed in a single transperitoneoscopy procedure. Three retroperitoneoscopies were converted to an open surgery due technical difficulties. A prolonged urinary leakage occurred in 3/35 cases (8.5{\%}) where 2 patients were treated by placing a ureteral catheter. Both laparoscopic groups have significantly less analgesia requirements and shorter hospitalization (p <0.001 and p = 0.003, respectively). All patients were stone-free in the follow-up 1-month visit. Conclusions: To our knowledge, this is the first prospective comparison of laparoscopic and open ureterolithotomy in a laparoscopic training scenario. Even though these procedures were performed by limited laparoscopic experience urologists, laparoscopy offered significant advantages over traditional open ureterolithotomy, resulting in improved analgesia, shorter hospital stays and similar complication rates.",
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AU - Heldwein, Flavio L.

AU - Graziotin, Tulio M.

AU - Schmitt, Caio S.

AU - Telöken, Cláudio

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N2 - Introduction and objectives: To investigate two ureterolithotomy approaches for treatment of large and impacted upper ureteral stones, we prospectively evaluated the perioperative features of consecutive patients submitted to ureterolithotomy following failure of endourological treatment. Methods: Of the 110 patients included in the study, 34 underwent laparoscopic ureterolithotomy. Patients were divided into three ureterolithotomy subgroups (group A, 76 open procedures; group B, 16 transperitoneoscopies and group C, 19 retroperitoneoscopies). All procedures were performed into a urology residency program. Results: The patients' age, sex, ASA classification and stones characteristics showed no significant difference between the groups. Overall, complication rates and the operation times recorded were similar. One patient had bilateral stones and both sides were managed in a single transperitoneoscopy procedure. Three retroperitoneoscopies were converted to an open surgery due technical difficulties. A prolonged urinary leakage occurred in 3/35 cases (8.5%) where 2 patients were treated by placing a ureteral catheter. Both laparoscopic groups have significantly less analgesia requirements and shorter hospitalization (p <0.001 and p = 0.003, respectively). All patients were stone-free in the follow-up 1-month visit. Conclusions: To our knowledge, this is the first prospective comparison of laparoscopic and open ureterolithotomy in a laparoscopic training scenario. Even though these procedures were performed by limited laparoscopic experience urologists, laparoscopy offered significant advantages over traditional open ureterolithotomy, resulting in improved analgesia, shorter hospital stays and similar complication rates.

AB - Introduction and objectives: To investigate two ureterolithotomy approaches for treatment of large and impacted upper ureteral stones, we prospectively evaluated the perioperative features of consecutive patients submitted to ureterolithotomy following failure of endourological treatment. Methods: Of the 110 patients included in the study, 34 underwent laparoscopic ureterolithotomy. Patients were divided into three ureterolithotomy subgroups (group A, 76 open procedures; group B, 16 transperitoneoscopies and group C, 19 retroperitoneoscopies). All procedures were performed into a urology residency program. Results: The patients' age, sex, ASA classification and stones characteristics showed no significant difference between the groups. Overall, complication rates and the operation times recorded were similar. One patient had bilateral stones and both sides were managed in a single transperitoneoscopy procedure. Three retroperitoneoscopies were converted to an open surgery due technical difficulties. A prolonged urinary leakage occurred in 3/35 cases (8.5%) where 2 patients were treated by placing a ureteral catheter. Both laparoscopic groups have significantly less analgesia requirements and shorter hospitalization (p <0.001 and p = 0.003, respectively). All patients were stone-free in the follow-up 1-month visit. Conclusions: To our knowledge, this is the first prospective comparison of laparoscopic and open ureterolithotomy in a laparoscopic training scenario. Even though these procedures were performed by limited laparoscopic experience urologists, laparoscopy offered significant advantages over traditional open ureterolithotomy, resulting in improved analgesia, shorter hospital stays and similar complication rates.

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KW - Ureteral calculi

KW - Ureteral obstruction

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