Department of Urology and the Department of Psychiatry (AA), C.S.M. Medical University (Upgraded King George Medical College), Lucknow, Uttar Pradesh, India.
J Urol. 2013 Mar;189(3):940-5. doi: 10.1016/j.juro.2012.09.114. Epub 2012 Sep 27.
We compared laparoscopic transperitoneal and retroperitoneal ureterolithotomy approaches, and determined whether one technique is superior to the other.
In this prospective randomized study from January 2009 to May 2012, 48 patients with proximal or mid ureteral stones underwent transperitoneal laparoscopic ureterolithotomy or retroperitoneal laparoscopic ureterolithotomy. The randomization occurred on a 1:1 basis. Groups 1 and 2 consisted of patients who underwent transperitoneal laparoscopic ureterolithotomy and retroperitoneal laparoscopic ureterolithotomy, respectively. Demographic and clinical characteristics as well as postoperative data were collected and analyzed. Statistical analysis was performed with SPSS® version 15.0 using the Fisher exact and Mann-Whitney U tests with p <0.05 considered statistically significant.
The difference in visual pain analog score and mean tramadol requirement on days 1 and 2 between the 2 groups was statistically significant, and was higher in group 1 (p <0.05). Postoperative hospital stay and paralytic ileus rates were significantly higher in group 1 (p <0.05). The differences in total operative time and intracorporeal suturing time between the 2 groups were not statistically significant. However, successful stone removal was equal in the 2 groups.
For proximal or mid ureteral large and impacted stones, transperitoneal laparoscopic ureterolithotomy is significantly associated with pain, greater tramadol requirement, ileus and longer hospital stay than retroperitoneal laparoscopic ureterolithotomy. However, successful stone removal remains the same in both groups.
我们比较了腹腔镜经腹腔和后腹腔输尿管切开取石术，并确定了一种技术是否优于另一种技术。
在这项前瞻性随机研究中，我们纳入了 48 例患有近端或中段输尿管结石的患者，分别采用经腹腔腹腔镜输尿管切开取石术和后腹腔镜输尿管切开取石术。随机分组采用 1:1 比例。第 1 组和第 2 组分别为接受经腹腔腹腔镜输尿管切开取石术和后腹腔镜输尿管切开取石术的患者。收集并分析了人口统计学和临床特征以及术后数据。使用 SPSS®版本 15.0 进行统计分析，采用 Fisher 确切检验和 Mann-Whitney U 检验，p<0.05 认为具有统计学意义。
两组患者在视觉模拟疼痛评分和术后第 1 天和第 2 天曲马多需求的平均值方面存在显著差异，第 1 组更高（p<0.05）。第 1 组的术后住院时间和麻痹性肠梗阻发生率明显更高（p<0.05）。两组之间的总手术时间和腔内缝合时间差异无统计学意义。然而，两组的结石清除率相等。
对于近端或中段输尿管大而嵌顿的结石，与后腹腔镜输尿管切开取石术相比，经腹腔腹腔镜输尿管切开取石术与疼痛、更大的曲马多需求、肠梗阻和更长的住院时间显著相关。然而，两组的结石清除率相同。
