Page 8 - World Journal of Laparoscopic Surgery

Bhanu P Sharma et al
converted). There was failure to dissect the pelvis in both CONCLUSION
cases, and, hence, it was difficult to locate the site of calcu- In conclusion, we would like to state that among the two
lus. Despite optimal port placement according to projected approaches, namely RPL and OP, RPL is a safe, simple,
site of the calculus (from preoperative KUB X-ray and IVP),
dissection was not possible and conversion was inevitable. and effective minimally invasive procedure with fewer
On converting, the pelvis was found to be enveloped by complications, less postoperative pain, better cosme-
peripelvic adhesions. sis, and a lesser hospital stay period. It can provide an
17
Chander et al evaluated the role of RPPL in the alternative to OP in almost all the cases.
management of renal calculi and found peritoneal rent in
five cases, superficial wound infection in two cases, and REFERENCES
10
prolonged leak in one patient. Yanev et al in their study 1. Borofsky MS, Lingeman JE. The role of open and laparoscopic
of retroperitoneal surgeries found subcutaneous emphy- stone surgery in the modern era of endourology. Nature Rev
18
sema in five cases (13.51%). Dongol et al in their study for Urol 2015 Jul;12(7):392-400.
retroperitoneoscopic management of renal stones found 2. Gupta M, Lee MW. Treatment of stones associated with
three patients with peritoneal rent, two patients with port complex or anomalous renal anatomy. Urol Clin North Am
site superficial wound infection, and one patient with pro- 2007 Aug;34(3):431-441.
longed leak. In our study, with regard to immediate com- 3. Eterović D, Juretić-Kuscić L, Capkun V, Dujić Z. Pyeloli-
thotomy improves while extracorporeal lithotripsy impairs
plications noted in both the groups, 8 patients presented kidney function. J Urol 1999 Jan;161(1):39-44.
with intraoperative bleeding, 5 with stone migration, 10 4. Stein RJ, Turna B, Nguyen MM, Aron M, Hafron JM, Gill IS,
with surgical emphysema, 15 with difficulty in accessing Kaouk J, Desai M. Laparoscopic pyeloplasty with concomitant
renal pelvis; with regard to late complications, 5 patients pyelolithotomy: technique and outcomes. J Endourol 2008
reported with prolonged leak in group I as compared Jun;22(6):1251-1255.
with 8 patients of renal parenchymal injury, 8 each with 5. Patloo AM, Sarmast AH, Khan MA, Khan MA, Zaz M, Khan MA,
bleeding and stone migration, 4 with difficulty in access- Showkat HI. Laparoscopic retroperitoneal pyelolithotomy
open pyelolithotomy: a comparative study. Turkish J Urol
ing renal pelvis, 8 with superficial wound infections as 2012 Dec;38(4):195-200.
immediate complication, 4 with wound gapping, and 8 6. Wang X, Li S, Liu T, Guo Y, Yang Z. Laparoscopic pyelolithot-
with prolonged leak in group II (Table 3). omy compared to percutaneous nephrolithotomy as surgical
9
Agarwal observed analgesia requirement in terms of management for large renal pelvic calculi: a meta-analysis.
days in a study conducted in laparoscopic group; it was J Urol 2013 Sep;190(3):888-893.
17
2.4 ± 0.9 days. In a study conducted by Chander et al, 7. Haggag YM, Morsy G, Badr MM, Al Emam AB, Farid M,
analgesia required was 102 ± 47.7 mg of diclofenac. Haggag Etafy M. Comparative study of laparoscopic pyelolithotomy
versus percutaneous nephrolithotomy in the management
7
et al found out in their study that postoperative analgesia of large renal pelvic stones. Can Urol Assoc J 2013 Mar-Apr;
requirement was 2.4 ± 0.9 days. In terms of postoperative 7(3-4):E171-E175.
analgesia requirement, it was observed that total need of 8. Qin C, Wang S, Li P, Cao Q, Shao P, Li P, Han Z, Tao J, Meng X,
analgesia in terms of days (given in form of Inj. diclofenac Ju X, et al. Retroperitoneal laparoscopic technique in treat-
75 mg im twice daily) was significantly less in group I ment of complex renal stones: 75 cases. BMC Urol 2014
Feb;14:16.
as compared with group II, which was 2.23 (with SD of 9. Agarwal G. The efficacy, safety & outcomes of laparoscopic
0.62) and 5.36 (with SD of 0.96) respectively. In terms of pyelolithotomy (retroperitoneoscopic pyelolithotomy) and
dose of diclofenac required, it was found that significant its comparison with percutaneous nephrolithotomy. Int
difference was present in laparoscopic (339 ± 93 mg) and J Biomed Adv Res 2015 Apr;6(4):363-367.
open (804 ± 144 mg) groups; analgesia required was less 10. Yanev K, Georgiev M, Ormanov D, Dimitrov PL, Vassilev V,
in the laparoscopic group. Kirilov S, Simeonov P, Panchev P. Retroperitoneoscopic oper-
19
Shamim and Iqbal conducted studies in patients who ations in urology – initial experience. J Clin Med 2009;2(2):
36-39.
underwent OP and found mean hospital stay of 5.37 days. 11. Farooq Qadri SJ, Khan N, Khan M. Retroperitoneal laparo-
20
Basiri et al, in their study, found a similar hospital stay scopic ureterolithotomy: a single centre 10 year experience.
of 3.4 days in the RLP group of 30 patients. Ghanghoria Int J Surg 2011;9(2):160-164.
21
et al found that the mean hospital stay in the laparo- 12. Leonardo C, Simone G, Rocco P, Guaglianone S, Di Pierro G,
17
scopic group was 4.4 days. Chander et al evaluated the Gallucci M. Laparoscopic ureterolithotomy: minimally inva-
role of RPPL in the management of renal calculi and sive second line treatment. Int Urol Nephrol 2011 Sep;43(3):
651-654.
found an average hospital stay of 3.12 days. In this study, 13. Karami H, Mazloomfard MM, Lotfi B, Alizadeh A, Javanmard B.
postoperative hospital stay was compared in both groups. Ultrasonography-guided PNL in comparison with laparo-
The hospital stay in group I was 3.76 days (with SD of scopic ureterolithotomy in the management of large proximal
1.55) and in group II, it was 5.36 days (with SD of 1.96). ureteral stone. Int Braz J Urol 2013 Jan-Feb;39(1):22-28.
6