Department of Urology, Shahid Labbafinejad Hospital, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Curr Opin Urol. 2013 Mar;23(2):169-74. doi: 10.1097/MOU.0b013e32835d307f.
While most renal and ureteral stones can be efficiently managed using endourologic techniques, the use of laparoscopy for the management of urolithiasis is increasing. The application of laparoscopy for stone removal will further reduce the need for open stone surgery.
Laparoscopic ureterolithotomy, pyelolithotomy, and anatrophic nephrolithotomy are highly successful techniques with regard to their one-session, high stone-free rates. These procedures could be considered as the preferred approaches when endourologic procedures are not available or have failed. Laparoscopic stone surgery (LSS) in patients with urinary tract anomalies offers a reliable minimally invasive procedure as an alternative to a complex endourologic technique.
Although laparoscopy still has a limited role in the urologist's armamentarium for the surgical management of urolithiasis, it can further reduce the need for open stone surgery in complex circumstances. LSS duplicates its open counterpart and offers a high one-session, stone-free rate in most patients with a lower morbidity and quicker convalescence. More comparative studies are needed to define the role and indications of LSS in relation to endourologic and open techniques, especially in complex circumstances.
虽然大多数肾结石和输尿管结石可以通过腔内泌尿外科技术有效地治疗，但腹腔镜技术在治疗尿路结石方面的应用正在增加。腹腔镜取石术的应用将进一步减少开放取石手术的需求。
腹腔镜输尿管切开取石术、肾盂切开取石术和解剖性肾切开取石术在单次手术中结石清除率高，是非常成功的技术。当腔内泌尿外科手术不可行或失败时，这些手术可以被视为首选方法。对于存在尿路畸形的患者，腹腔镜结石手术 (LSS) 是一种可靠的微创方法，可替代复杂的腔内泌尿外科技术。
尽管腹腔镜在泌尿外科医生治疗尿路结石的手术方法中仍有一定的局限性，但在复杂情况下，它可以进一步减少开放取石手术的需求。LSS 复制了开放手术，在大多数患者中实现了单次手术、高结石清除率，且具有较低的发病率和更快的康复。需要更多的比较研究来确定 LSS 与腔内泌尿外科和开放技术相关的作用和适应证，特别是在复杂情况下。
