Comparison of the Safety and Efficacy between Transperitoneal and Retroperitoneal Approach of Laparoscopic Ureterolithotomy for the Treatment of Large (>10mm) and Proximal Ureteral Stones: A Systematic Review and Meta-analysis
Urology Journal,
,
5 January 2019
,
Page 5588
https://doi.org/10.22037/uj.v16i7.5588
Abstract
Purpose: We aimed to compare the safety and efficacy between laparoscopic transperitoneal ureterolithotomy (LTU) and laparoscopic retroperitoneal ureterolithotomy (LRU) in the treatment of large (>10mm) and proximal ureteral stones.
Materials and Methods: Electronic databases, including PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus searched through December 2019. Comparative studies were comparing two approaches included. The primary outcome was a single-procedure success rate; the secondary outcomes included operative time, hospital duration, and complications (according to the Clavien-Dindo Grade). Newcastle–Ottawa scale (NOS) and the modified Jadad scale was used to evaluate the quality of the included studies. The Egger's test estimated publication bias. The meta-analysis was performed by Review Manager 5.3 and STATA 15.0.
Results: 7 studies, involving 125 participants in LTU group and 128 in LRU group, were included in the study. The results suggested that both single-procedure success rate and the rate of postoperative paralytic ileus were significantly higher in LTU group than in LRU group (95.2% vs 87.5%, 95% CI: .00-.16, RD = .08, P = .04; 10.4% vs 0, 95% CI: .02- .19, RD = .10, P = .02, respectively). No publication bias of the primary outcome was observed with the Egger’s test (P = .117). No significant differences were noted in terms of operative time and hospital duration (95% CI: -18.95-8.80, MD = -5.08, P = .47; 95% CI: -.98- .58, MD = -.20, P = .61, respectively). Additionally, according to Clavien-Dindo Grade, the rates of major complications (>= Grade 3a) including open conversion (.8% vs 5.5%, 95%CI: -.11- .01, RD = -.05, P = .12), stone migration (8.1% vs 6.7%, 95% CI: -.08- .11, RD = .02, P = .76), vascular injury (5.4% vs 0, 95%CI: -.03- .14, RD = .05, P = .21) and ureteral stricture (1.3% vs 5.3%, 95% CI: -.11- .02, RD = -.04, P = .20), were comparable between two groups.
Conclusion: In the treatment of large and proximal ureteral calculi, LTU has a significantly higher single-procedure success rate and a higher rate of postoperative paralytic ileus than LRU. However, the complication was well-tolerated. The small sample size and limited, including studies, were the main limitations.
- laparoscopy
- meta-analysis
- retroperitoneal
- transperitoneal
- ureteral calculus
- ureterolithotomy
How to Cite
References
Zumstein V, Betschart P, Abt D, Schmid HP, Panje CM, Putora PM. Surgical management of urolithiasis - a systematic analysis of available guidelines. BMC Urology. 2018;18:25.
Research H-GTJU. Removal of ureteral stones with extracorporeal shock wave lithotripsy and ureteroscopic procedures. What can we learn from the literature in terms of results and treatment efforts? Urological Research. 2005;33:185-90.
Stewart GD, Bariol SV, Moussa SA, Smith G, ., Tolley DA, %J International Journal of Clinical Practice. Matched pair analysis of ureteroscopy vs. shock wave lithotripsy for the treatment of upper ureteric calculi. International Journal of Clinical Practice. 2010;61:784-8.
Drake T, Grivas N, Dabestani S, et al. What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review. European Urology Supplements. 2017;72:772.
Torricelli FCM, Monga M, Marchini GS, Srougi M, Nahas WC, Mazzucchi EJIBJoUOJotBSoU. Semi-rigid ureteroscopic
lithotripsy versus laparoscopic ureterolithotomy for large upper ureteral stones: a meta – analysis of randomized controlled trials. International braz j urol. 2016;42:645-54.
El-Moula MG, Abdallah A, El-Anany F, et al. Laparoscopic ureterolithotomy: Our experience with 74 cases. International Journal of Urology. 2010;15:593-7.
Dindo D. The Clavien–Dindo Classification of Surgical Complications. Annals of Surgery. 2009;250:187.
Abat D, Altunkol A, Kuyucu F, Demirci DA, Vuruskan E, Bayazit YJJtJotPMA. After a urological laparoscopic training programme, which laparoscopic method is safer and more feasible in the management of proximal ureteral stones: Transperitoneal or retroperitoneal? Jpma the Journal of the Pakistan Medical Association. 2016;66:971.
Vishwajeet S, Rahul Janak S, Dheeraj Kumar G, Manoj K, Asif AJJoU. Transperitoneal versus retroperitoneal laparoscopic ureterolithotomy: a prospective randomized comparison study. The Journal of Urology. 2013;189:940-5.
Almeida GL, Heldwein FL, Graziotin TM, Schmitt CS, Cláudio TKJAUE. Prospective trial comparing laparoscopy and open surgery for management of impacted ureteral stones. Actas Urológicas Españolas. 2009;33:1108-14.
Chiu HC, Chang CH, Wu HC, Huang CPJEUS. 982 The comparison of peritoneal, retro-peritoneal and transperitoneal robotic assisted laparoscopic ureterolithotomy for large proximal ureteral stone. European Urology Supplements. 2015;14:e982-ea.
Khalil M, Omar R, Abdel-Baky S, Mohey A, Sebaey AJTJU. Laparoscopic ureterolithotomy; which is better: Transperitoneal or retroperitoneal approach? Turk J Urol. 2015;41:185-90.
Pierluigi B, Salvatore M, Roberto M, et al. Laparoscopic ureterolithotomy: a comparison between the transperitoneal and the retroperitoneal approach during the learning curve. Journal of Endourology. 2009;23:953-7.
Wisoot K, Sahachart A, Kittinut K, Suthep P, Suchart CJJotMAoTCt. Extraperitoneal versus transperitoneal approach of laparoscopic ureterolithotomy in selected patients. Journal of the Medical Association of Thailand = Chotmaihet thangphaet. 2010;93:794-8.
Wu T, Duan X, Chen S, Yang X, Tang T, Cui SJUI. Ureteroscopic Lithotripsy versus Laparoscopic Ureterolithotomy or Percutaneous Nephrolithotomy in the Management of Large Proximal Ureteral Stones: A Systematic Review and Meta-Analysis. Urologia Internationalis. 2017.
Khalil M, Omar R, Abdel-Baky S, Mohey A, Sebaey AJTJU. Laparoscopic ureterolithotomy; which is better: Transperitoneal or retroperitoneal approach? Journal of Urology. 2015;41:185-90.
Khalil M, Omar R, Abdel-Baky S, Mohey A, Sebaey A. Laparoscopic ureterolithotomy; which is better: Transperitoneal or retroperitoneal approach? Turk J Urol. 2015;41:185-90.
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