Comparative study on ureteroscopic lithotripsy and laparoscopic ureterolithotomy for treatment of unilateral upper ureteral stones

purpose: to compare the curative effects of ureteroscopic lithotripsy and laparoscopic ureterolithotomy for unilateral upper ureteral stones, and to explore optimal surgical indications and skills. methods: fifty cases of unilateral upper ureteral stones were randomly divided into two groups: one group underwent ureteroscopic holmium laser lithotripsy under epidural or lumbar anesthesia (n=25), and another group underwent laparoscopic ureterolithotomy under general anesthesia (n=25). double-j stent was routinely indwelled in both groups. operating time, postoperative hospitalization time, stone clearance rate and perioperative complications were compared. results: operation was successfully performed in all 50 cases, and no open surgery was converted in any case. in the ureteroscopy and laparoscopy groups, the mean operating time was 49.0±10.7 min and 41.8±8.0 min (t=2.68, p=0.00999), respectively, their hospitalization time was 2.8±1.3 days vs. 2.9±0.8 days (t =-0.40, p=0.69413), and stone clearance rate was 88.0% (22/25) vs. 100% (25/25). stone moved to the renal pelvis in three cases in the ureteroscopy group, and residual stones were removed by extracorporeal shock-wave lithotripsy (eswl). all patients were followed up for more than three months, and no serious complications such as ureterostenosis occurred. conclusions: laparoscopic ureterolithotomy has a higher stone clearance rate and shorter operation time compared with ureteroscopic lithotripsy. laparoscopic ureterolithotomy is one safe and effective treatment on unilateral upper ureteral stones.