Laparoscopic Pyelolithotomy for the Management of Large Renal Stones with Intrarenal Pelvis Anatomy
Urology Journal,
Vol. 18 No. 01 (2021),
17 March 2021
,
Page 47-51
https://doi.org/10.22037/uj.v18i01.5576
Abstract
Purpose: The role of laparoscopic pyelolithotomy (LPL) in the management of renal stones is evolving. One of
the challenges in LPL for renal stones is patients with intrarenal pelvis. Here we present our experience with laparoscopic pyelolithotomy for the management of renal stones with intrarenal pelvis anatomy.
Materials and Methods: Patients candidate for laparoscopic pyelolithotomy from February 2014 to March 2015
were included. Intrarenal pelvis was defined as > 50% of the renal pelvis area contained inside renal parenchyma. Laparoscopic pyelolithotomy was done by transperitoneal approach. Residual stones were checked by computed tomography and/or intravenous pyelography and ultrasonography 6 weeks after the operation.
Results: 28 patients were included in this study. The mean±SD of patients’ age was 45.8±12.5 years. 19 patients
(68%) were male. Stone locations were pelvis, multiple, and staghorn in 22, 3, and 3 patients respectively. The
mean±SD of operation duration was 160±48 minutes. Residual stones were observed in 3 patients with multiple
(n=2) or staghorn (n=1) stones. Urinary leak was observed in 3 patients and was managed conservatively in 2
patients. In one patient ureteral stent was inserted by cystoscopy. No conversion to open surgery or re-operation occurred.
Conclusion: Laparoscopic pyelolithotomy is a feasible operation for patients with renal stones and intrarenal
pelvis in centers with adequate experience in laparoscopy. However, the success of LPL decreases in patients with multiple stones and intrarenal pelvis.
- laparoscopy
- urolithiasis
- intrarenal
- kidney anatomy
How to Cite
References
Aminsharifi A, Hosseini MM, Khakbaz A. Laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for a solitary renal pelvis stone larger than 3 cm: a prospective cohort study. Urolithiasis. 2013;41:493-7.
Nouralizadeh A, Simforoosh N, Soltani MH, et al. Laparoscopic transperitoneal pyelolithotomy for management of staghorn renal calculi. J Laparoendosc Adv Surg Tech A. 2012;22:61-5.
Simforoosh N, Aminsharifi A. Laparoscopic management in stone disease. Curr Opin Urol. 2013;23:169-74.
Lee JW, Cho SY, Jeong CW, et al. Comparison of surgical outcomes between laparoscopic pyelolithotomy and percutaneous nephrolithotomy in patients with multiple renal stones in various parts of the pelvocalyceal system. J Laparoendosc Adv Surg Tech A. 2014;24:634-9.
Gaur DD, Agarwal DK, Purohit KC, Darshane AS. Retroperitoneal laparoscopic pyelolithotomy. J Urol. 1994;151:927-9.
Al-Hunayan A, Khalil M, Hassabo M, Hanafi A, Abdul-Halim H. Management of solitary renal pelvic stone: laparoscopic retroperitoneal pyelolithotomy versus percutaneous nephrolithotomy. J Endourol. 2011;25:975-8.
Gaur DDP, H.M.; Madhusudhana, H.R.; Rathi, S.S. Retroperitoneal laparoscopic pyelolithotomy: how does it compare with percutaneous nephrolithotomy for larger stones? Minimally Invasive Therapy & Allied Technologies. 2001;10:105-9.
Goel A, Hemal AK. Evaluation of role of retroperitoneoscopic pyelolithotomy and its comparison with percutaneous nephrolithotripsy. Int Urol Nephrol. 2003;35:73-6.
Haggag YM, Morsy G, Badr MM, Al Emam AB, Farid M, Etafy M. Comparative study of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in the management of large renal pelvic stones. Can Urol Assoc J. 2013;7:E171-5.
Meria P, Milcent S, Desgrandchamps F, Mongiat-Artus P, Duclos JM, Teillac P. Management of pelvic stones larger than 20 mm: laparoscopic transperitoneal pyelolithotomy or percutaneous nephrolithotomy? Urol Int. 2005;75:322-6.
Nambirajan T, Jeschke S, Albqami N, Abukora F, Leeb K, Janetschek G. Role of laparoscopy in management of renal stones: single-center experience and review of literature. J Endourol. 2005;19:353-9.
Tefekli A, Tepeler A, Akman T, et al. The comparison of laparoscopic pyelolithotomy and percutaneous nephrolithotomy in the treatment of solitary large renal pelvic stones. Urol Res. 2012;40:549-55.
Li S, Liu TZ, Wang XH, et al. Randomized controlled trial comparing retroperitoneal laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for the treatment of large renal pelvic calculi: a pilot study. J Endourol. 2014;28:946-50.
Wang X, Li S, Liu T, Guo Y, Yang Z. Laparoscopic pyelolithotomy compared to percutaneous nephrolithotomy as surgical management for large renal pelvic calculi: a meta-analysis. J Urol. 2013;190:888-93.
Tomaszewski JJ, Cung B, Smaldone MC, et al. Renal pelvic anatomy is associated with incidence, grade, and need for intervention for urine leak following partial nephrectomy. Eur Urol. 2014;66:949-55.
Tomaszewski JJ, Smaldone MC, Cung B, et al. Internal validation of the renal pelvic score: a novel marker of renal pelvic anatomy that predicts urine leak after partial nephrectomy. Urology. 2014;84:351-7.
Desai M, De Lisa A, Turna B, et al. The clinical research office of the endourological society percutaneous nephrolithotomy global study: staghorn versus nonstaghorn stones. J Endourol. 2011;25:1263-8.
- Abstract Viewed: 154 times
- 5576/pdf Downloaded: 104 times