Retroperitoneoscopic ureterolithotomy.
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ABSTRACT:
SUBMITTER: Modi P
PROVIDER: S-EPMC3193752 | biostudies-literature | 2011 Jul
REPOSITORIES: biostudies-literature
Publications
Retroperitoneoscopic ureterolithotomy.
Modi Pranjal P Vyas Jigish J Dholaria Pankaj P Sharma Varun V
Indian journal of urology : IJU : journal of the Urological Society of India 20110701 3
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| S-EPMC3193751 | biostudies-literature
Project description:We report the first case of a previously undocumented complication after posterior retroperitoneal adrenalectomy (PRA). Extensive diagnostic procedures for persisting abdominal pain led to diagnosis of an incisional hernia (IH) approximately 2.5 years after surgery for a pheochromocytoma of the right adrenal gland. Thus, IHs need to be recognized as a potential complication after PRA, particularly if the symptoms are non-specific. The differential diagnosis of an IH after PRA includes a type of spontaneous lumbar hernia due to a pre-existing weakness of the abdominal wall however the treatment for both type of hernias is similar by mesh repair. A possible risk factor for IH after PRA might be obesity, due to different factors including difficulties in closing the fascia in depth under subcutaneous tissue.
| S-EPMC7225460 | biostudies-literature
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| S-EPMC7587493 | biostudies-literature
Project description:Trans-peritoneal laparoscopic ureterolithotomy is a well-established minimally invasive procedure for management of large impacted ureteric stones since the last 3 decades. We present a case of a 51-year old gentleman, who presented with bilateral large upper ureteric calculi with obstructive uropathy and azotemia, managed successfully with bilateral synchronous 3-port trans-peritoneal laparoscopic ureterolithotomy, and to our knowledge is the first such case to be reported in literature.Supplementary informationThe online version contains supplementary material available at 10.1007/s42399-022-01190-5.
| S-EPMC9172089 | biostudies-literature
Project description:BackgroundThe ideal treatment for upper ureteric calculi is still debatable, particularly for patients with large, impacted ureteric calculi. Retroperitoneal laparoscopic ureterolithotomy (RLU) may be a worthwhile alternative to open surgery. In this study, we retrospectively evaluated our clinical experience associated with RLU performed for impacted upper ureteric calculi (>1.5 cm) help urologists in clinical practice and provide a reference for clinical work.MethodsA total of 64 cases (38 males; 26 females) with impacted upper ureteric calculi between April 2018 and January 2020 were analyzed retrospectively. The basic information of the included research subjects are as follows: The mean age was 50.8±25.4 years. The largest stone diameter was 1.8±0.3 cm. The mean stone retention time was 42±11 days. The mean degree of hydronephrosis was 2.8±1.2 cm.ResultsThe mean operative time was 85.4±18.3 minutes. The mean hospital duration was 7.5±1.8 days. The stone-free rate was 98.4%. Two patients required additional intervention. Post-operative fever developed in 3 patients. The decrease in hemoglobin levels was 7.8±3.6 g/L. The increase in procalcitonin (PCT) level was 3.7±1.8 ng/mL. No major complications, for example, sepsis, bleeding, bowel injury, or cardiopulmonary morbidities, were reported.ConclusionsRLU should be regarded as an excellent first line treatment modality for impacted upper ureteric calculi (>1.5 cm) owing to the high success rate, low complication rate, and the short length of operative time and hospital duration.
| S-EPMC8824816 | biostudies-literature
Project description:BackgroundThe aim of this study was to evaluate the role of flexible cystoscopy in preventing malpositioning of the ureteral stent after laparoscopic ureterolithotomy in male patients.MethodsFrom April 2009 to June 2015, 97 male patients with stones >1.8 cm in the upper ureter underwent intracorporeal double-J stenting of the ureter after laparoscopic ureterolithotomy performed by four different surgeons. In the last 50 patients who underwent laparoscopic ureterolithotomy flexible cystoscopy was performed through the urethral route to confirm the position of the double-J stent, while in the first 47 correct positioning of the stent was confirmed through postoperative KUB. The demographic data and perioperative outcomes were reviewed retrospectively. Penalized logistic regression analysis was used to evaluate the effects of flexible cystoscopy.ResultsUpward malpositioning of the ureteral stent was found in 9 of the 47 (19.1%) patients who underwent surgery without flexible cystoscopy. Among the 50 most recent patients who underwent surgery with flexible cystoscopy through the urethral route, upward malpositioning was observed in 10 (20%) patients. The factors preventing upward malpositioning of the double-J catheter in multivariate analysis were surgeon (p = 0.039) and use of flexible cystoscopy (p = 0.008).ConclusionFlexible cystoscopy is a simple, safe, quick, and effective method to identify and correct malpositioning of double-J stents, especially in male patients.Trial registrationThis study was registered with ClinicalTrials.gov Registry on May 11, 2017 (retrospective registration) with a trial registration number of NCT03150446 .
| S-EPMC5472879 | biostudies-literature
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| S-EPMC11634096 | biostudies-literature
Project description:BackgroundSince 2017, switching from laparoscopic transabdominal adrenalectomy (LTA), posterior retroperitoneoscopic adrenalectomy (RPA) is used as standard procedure in this institution. Aim of this retrospective study was to compare both techniques regarding operative time, length of stay and safety of the procedures.MethodsAll patients operated in our institution for adrenal tumors were prospectively documented in the EUROCRINE-database and retrospectively analyzed. Sex, age, body mass index (BMI), indication, operative time, conversion and complication rates, hospital stay and tumor-size were analyzed by Z-score, chi-square test, t-test, Mann-Whitney U test and Pearson correlation.ResultsA total of 105 RPAs and 132 LTAs were performed in an 8-year period. No difference was seen in age, sex and tumor localization. Adenoma (n=113) and pheochromocytoma (n=64) were the most common histopathological findings. Compared to the LTA group, the RPA group had significantly shorter operative time with a median of 50 (15-380) vs. 125 (25-420) min (P<0.001) and shorter hospital stay with a median of 3 vs. 9 days (P<0.001). The decrease of the median operative time in RPA group, visualizing the learning curve of the procedure, was from 60 min (2017) to 45 min (2020). Four conversions from RPA to open adrenalectomy had to be performed due to bleeding or adhesions, whereas 9 LTA procedures had to be converted due to bleeding (n=2), unclear anatomy (n=1), adhesions (n=1), difficult access (n=1) or planned conversion (n=4).ConclusionsRPA could be safely introduced with reduced operative times and shorter length of hospital stay compared to LTA.
| S-EPMC11635560 | biostudies-literature
Project description:Metastasectomy is a widely accepted treatment for renal cell carcinoma (RCC) metastasis, and is regarded as the most effective strategy for increasing the rate of cancer-specific survival. However, since bilateral synchronous or metachronous adrenal metastasis of RCC is extremely rare, a standard approach has yet to be established. Partial adrenalectomy may avoid lifelong hormonal supplementation and reduce the risk of Addisonian crisis. A 71-year-old man had a previous history of left nephrectomy and ipsilateral adrenalectomy for metachronous adrenal metastasis. Metachronous contralateral adrenal metastasis was detected 2 years after ipsilateral adrenalectomy, and he underwent retroperitoneoscopic partial adrenalectomy using a vessel sealing device. Although corticosteroid replacement therapy was not prophylactically performed, the patient did not exhibit any symptoms of hypocorticism. Nine months after the surgery, the patient remains well without steroid supplementation, and neither local recurrence nor metastasis has been detected. To the best of our knowledge, this is the first case report of laparoscopic partial adrenalectomy for RCC metastasis. The vessel sealing device was highly effective and suitable for laparoscopic partial adrenalectomy.
| S-EPMC6942610 | biostudies-literature
Project description:OBJECTIVES: To summarize our experience of retroperitoneal laparoscopic ureterolithotomy for ureteral calculi and evaluate the safety and efficiency of this procedure. METHODS: We conducted a retrospective analysis of 197 patients with proximal ureteral calculi who accepted retroperitoneal laparoscopic ureterolithotomy from June 2005 to June 2014. RESULTS: All procedures were performed successfully and the mean operating time and estimated blood loss were 87 min and 64 mL. The clearance rate was 98.5% and the rates of urine leak and ureteral stricture were 2.5% and 1.0%. CONCLUSIONS: Retroperitoneal laparoscopic ureterolithotomy is a safe and effective procedure for patients with complex stones or anatomic abnormalities, and, with experience of high volume series, it is also a reasonable choice as the primary treatment for such selected patients.
| S-EPMC4273536 | biostudies-other