Assessment of the suitability of retroperitoneal laparoscopic ureterolithotomy as a treatment for complex proximal ureteral calculi

Aim. This retrospective study aimed to evaluate the suitability of retroperitoneal laparoscopic ureterolithotomy (RPLU) in the treatment of complex proximal ureteral calculi. Methods. Included were 24 patients who underwent RPLU for complex proximal ureteral stones from November 2008 to June 2010. Results. A retroperitoneal approach was performed in 23 patients with a mean operative time of 79.6 min (range of 65-130 nun) and mean intraoperative blood loss of 20.1 mL (10-50 mL). No postoperative complications were encountered within during the follow-up period of 9.1 months (3-22 months). Only one patient who underwent RPLU within one week of failed ESWL was converted to open surgery due to severe adhesions around ureter and the injury of aberrant renal artery at the lower pole of left kidney encountered during the RPLU. Conclusion. RPLU is safe and effective in the treatment of complex upper ureteral stones and can become a first-line surgical management of the disease.