Department of Urology, Sohag University Hospital , Sohag, Egypt.
J Endourol. 2011 May;25(5):825-30. doi: 10.1089/end.2010.0628. Epub 2011 Apr 3.
To determine the necessity of ureteral stent placement after retroperitoneal laparoscopic ureterolithotomy (RLU) for upper ureteral stones more than 1 cm.
Between May 2006 and May 2009, 104 RLUs were performed as primary management of large upper ureteral stones. The patients were randomly divided into two groups: In group 1 (52 patients), RLU was performed without stent placement afterward, and in group 2 (52 patients), the stent was placed after RLU. The mean stone size was 16.8 cm in group 1 and 18.2 cm in group 2. The stent in group 2 was placed cystoscopically.
All procedures were performed successfully. The mean operative time was 48 minutes in group 1 vs. 65 minutes in group 2. The mean drainage time was 4.1 days in group 1 vs. 2.3 days in group 2. All the patients were followed up for a period of 6 months with no recorded cases of residual stone or ureteral stricture.
RLU for large upper ureteral stones could be considered as a primary line for treatment as regards the economic status in developing countries. Laparoscopic ureterolithotomy (LU) without stent placement for upper ureteral stones is safe, cost effective, has less operative time, and needs no auxiliary procedures when compared with the use of stent placement after LU, which adds costs and discomfort for the patient.
探讨后腹腔镜输尿管切开取石术（RLU）治疗大于 1cm 的上段输尿管结石是否需要留置输尿管支架。
2006 年 5 月至 2009 年 5 月，对 104 例较大的上段输尿管结石患者行 RLUs 作为初始治疗。将患者随机分为两组：第 1 组（52 例）术后不放置支架，第 2 组（52 例）术后放置支架。第 1 组的平均结石大小为 16.8cm，第 2 组为 18.2cm。第 2 组的支架经膀胱镜放置。
所有手术均成功完成。第 1 组的平均手术时间为 48 分钟，第 2 组为 65 分钟。第 1 组的平均引流时间为 4.1 天，第 2 组为 2.3 天。所有患者均随访 6 个月，无残留结石或输尿管狭窄的病例记录。
对于发展中国家的经济状况，RLU 可作为治疗大的上段输尿管结石的一线治疗方法。与 LU 后放置支架相比，LU 不放置支架治疗上段输尿管结石安全、经济有效，手术时间更短，且无需辅助手术，为患者增加了成本和不适。
