Analysis of the clinical effect and long-term follow-up results of retroperitoneal laparoscopic ureterolithotomy in the treatment of complicated upper ureteral calculi (report of 206 cases followed for 10 years)

Purpose To summarize the experience of retroperitoneal laparoscopic ureterolithotomy (RLU) in the treatment of upper ureteral calculi and long-term follow-up results and compare them with ureteroscopic lithotomy (URL) and percutaneous nephrolithotomy (PCNL). Methods The clinical data of 585 patients with complex upper ureteral calculi who met the inclusion criteria from January 2006 to December 2017 were retrospectively analyzed. There were 206 cases treated with RLU, 201 cases treated with URL and 178 cases treated with PCNL. The operation time, hospitalization time, stone clearance rate, incidence of postoperative complications and recurrence rate were observed and compared among the three groups. Results Among 585 eligible patients, 206 cases were treated with RLU, 201 cases were treated with URL and 178 cases were treated with PCNL. The stone clearance rate (98.54%), postoperative complication types and rate (0.97%) in the RLU group were superior to those in the URL group and the PCNL group (P < 0.05). There was no significant difference in the recurrence rate (3.88%) between the RLU group and the other two groups (P > 0.05). Conclusion Retroperitoneal laparoscopic ureterolithotomy has many advantages in the treatment of upper ureteral calculi, including high stone clearance rate, less complications especially in ureteral stricture. Retroperitoneal laparoscopic ureterolithotomy is also safe to treat upper ureteral calculi accompanied with severe urinary tract infection.