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  • Title: [Retroperitoneal laparoscopy for the management of lumbar ureter stones].
    Author: Derouiche A, Belhaj K, Garbouj N, Hentati H, Ben Slama MR, Chebil M.
    Journal: Prog Urol; 2008 May; 18(5):281-7. PubMed ID: 18538272.
    Abstract:
    INTRODUCTION: Retroperitoneal laparoscopy is a recent alternative to conventional surgical treatment of ureterolithiasis. The objective of this study was to evaluate the place of retroperitoneal laparoscopic ureterolithotomy. MATERIAL AND METHODS: The authors report 50 cases of retroperitoneal laparoscopy for lumbar ureter stones performed in 49 patients between January 2001 and December 2006. The indications were a very large (>15 mm) obstructive stone in the lumbar ureter in 88% of cases, failure of extracorporeal shock wave lithotripsy (ESWL) in 6% of cases and refusal of ESWL in 6% of cases. RESULTS: The mean stone diameter was 17 mm (range: 10-35 mm). The stone was removed by retroperitoneal laparoscopy in 46 out of 50 cases (92%). The mean operating time was 97 min. (range: 35-170 min.). The surgical conversion rate was 8%. Ten patients (20%) developed a urinary fistula requiring secondary drainage by double J ureteric stent. The mean hospital stay was 6.8 days. No cases of ureteric stenosis or kidney destruction was observed with a mean follow-up of 32 months. CONCLUSION: Retroperitoneal laparoscopic lumbar ureterolithotomy is a safe, effective and minimally invasive technique which could constitute an alternative to open ureterolithotomy in the majority of its current indications.
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