LAPAROSCOPIC TREATMENT OF URINARY STONES AFTER FAILURE OF PREVIOUS MINI-INVASIVE APPROACHES
From September 2010 until April 2012 18 patients, previously treated with minimally invasive techniques underwent laparoscopic surgery for urinary stones. No patient had associated morbidities that required any other additional procedure (pyelo-ureteral junction obstruction, urinary diversions, etc). 18 laparoscopic procedures were performed: 9 ureterolithotomies, 6 cystolithotomies, 3 pyelolithotomies. The mean patient age was 48 years (27-66 years), all Caucasian subjects: 14 males and 4 females. No patients had acute renal failure. 2 patients presented a blilateral position of the stones. Stone localization was: 9 ureteral,6 in the bladder and 3 in the renal pelvis.
The mean operative time was: ureteral stone 82 ± 23 minutes, bladder stone 47 ± 10 minutes, and kidney stone 99 ± 26 minutes.
Mean hospital stay was 3 days (2 – 4 days). The overall stone clearance rate was 88.9% (16/18), and two patients had residual kidney stones that were managed with extracorporeal shock wave lithotripsy. At a mean follow-up of 6 months no serious complications (bleeding, sepsis, bowel injury, ureterostenosis, or urinary likeage) occurred.
Laparoscopic surgery is an effective safe technique for the management of urinary tract stone disease with a high stone clearence rate.