Akademik Veri Yönetim Sistemi
Gazi Medical Journal, cilt.23, sa.2, ss.46-50, 2012 (Scopus)
Objective: To compare the efficacy of laparoscopic ureterolithotomy, antegrade percutaneous ureterolithotomy (PNL), and retrograde ureteroscopic lithotripsy (URS) in the treatment of large, impacted proximal ureteral stones. Methods: Patients with large impacted ureteral stones were included on condition that their data was available retrospectively. Twenty five patients were selected randomly for each group. Patients on permanent anticoagulants or those with ureteral strictures, multiple stones, anatomical abnormalities, or renal insufficiency were excluded. Patient characteristics along with preoperative and postoperative findings were analyzed. Results: A total of 75 patients were included. There was no difference in the groups in terms of patient age, gender, or stone size (p>0.05). Regarding postoperative stone-free rates, the URS group had significantly lower rates compared with the other groups (p=0.011). Decreases in hematocrit and analgesic values were significantly different between groups, with the lowest being in the URS group and the highest in PNL group. The duration of hospitalization was also significantly different between the three groups and was highest in the laparoscopy group. The operation time was shortest in the URS group and was significant (p=0.21). The need for a secondary intervention was also significantly higher in the URS group (p=0.037). Conclusion: Laparoscopic ureterolithotomy and PNL had high rates of success, but URS performed with a pneumotic lithotriptor had disadvantages, such as a low success rate and high rate of secondary intervention. PNL and laparoscopic ureterolithotomy should be considered as the first treatments of choice provided there is the necessary surgical experience and equipment available. ©Copyright 2012 by Gazi University Medical Faculty.