Comparison of Open Ureterolithotomy and Laparoscopic Ureterolithotomy in Ureteral Stones at Rural Hospital

Abstract

Treatment of ureterolithiasis has switched to mini-invasive procedures, such as ESWL and ureteroscopy. The laparoscopic ureterolithotomy method is more helpful for large and hard ureteral stones and minimizes the incidence of sepsis than ESWL or ureteroscopy. This study aims to compare open ureterolithotomy and laparoscopic ureterolithotomy. This retrospective cohort study used 27 samples. The inclusion criteria of this study were patients with proximal ureteral stones, having a stone size >2 cm, confirmed by CT scan findings, and receiving an open ureterolithotomy or retroperitoneal laparoscopic ureterolithotomy. The data collected has demographic characteristics and perioperative and postoperative parameters. Operating time in the laparoscopic group (171.00 + 19.12 minutes) is longer than open ureterolithotomy (83.24 + 7.49 minutes) with p-values of 0.001. Average blood loss (51.30 + 12.04 ml) and analgesic needed (880.00 + 647.73 mg) were better in the laparoscopic group, with each p-value being 0.006 and 0.004. Longer hospital stay was found in the open group with a mean is 2.53 + 0.80 days (p =0.005). Perioperative complications were found in 1 person in the laparoscopic group (p = 0.370) and three postoperative complications in the open group (p = 0.274). Laparoscopic ureterolithotomy is effective and safe for proximal urethral stones larger than 2 cm.