Abstract

Objective: To discuss the efficacy, safety and feasibility of retroperitoneal Laparoendoscopic Single-Site (LESS) Ureterolithotomy.

Methods: Selected all the patients who met the inclusion criteria and confirmed to be upper and middle ureteral calculus by imaging tests from the department of Urology,the First Affiliated Hospital of Medical College of Shihezi University in the period of July 2011 to July 2012,the patients met t were randomly divided into single-site retroperitoneal laparoendoscopic group (group A) and standard retroperitoneal laparoscopic group (group B).The various efficacy indicators between two groups were compared by SPSS 17.0 software.

Results: 12 cases of group A and 15 cases of group B fit for the stduy were collected.All the operations were completed successful,without conversion to standard laparoscopic or open surgeries,all stones were successfully removed and no major perioperative complications occured. As to blood loss, postoperative bowl function recovery time,drain volume,drain removal time and postoperative hospital stay,the two groups had no signifieant difference (P>0.05).As to operative time,group A was longer than group B (P<0.05).As patient’s satisfaction and postoperative cosmetic results,group A was better than group B (P<0.05).1 patient used analgesic drugs the second day postoperated in group B,no analgesic drugs used in group A. All patients showed no residual stones and ureteral obstructions or stenosis postoperatively reached 1-3 month follow-up.1 patient’s double-J tube was removed by ureteroscope be hospitalized caused by retracted into uerter three months after surgery.All patients showed no residual stones and hydronephrosis 1-3 month follow up after double-J tube removal.

Conclusions: Retroperitoneal LESS ureterolithotomy is safe and feasible, but the operation difficulty is hard, Learning curve is longer, still needs larger series and follow-up study to further evaluate its long-term benefits. Althogh there are some defects in LESS technology presently, we believe with the accumulation of experience of surgeons and improvement of special equipments, the benefits of LESS will be obviously, achieve more social and economic benefits finally. It’s the trend of the development of minimally incasive surgery, it is worth clinical promotion.

Key words Retroperitoneal Laparoendoscopic Single-Site; Standard Retroperitoneal Laparoscopic; Ureterolithotomy