Management of Migrated or Residual Stones Following Laparoscopic Pyelolithotomy and Ureterolithotomy in Abnormal Kidneys: A Prospective and Randomized Comparison

作者：Wenfeng Guan, Shubo Fan, Jian Liang, Nengzhuo Feng, Qiyan Liang, Yixing Huang, Wenchao Qin, Jingwei He, Kunlin Yang, Jun Xie, Xuesong Li · 发表于：Journal of Endourology · 年份：2020 · DOI：10.1089/end.2020.0296 · 被引用次数：2 · 研究领域：Kidney Stones and Urolithiasis Treatments、Pediatric Urology and Nephrology Studies、Urological Disorders and Treatments

Objective: To conduct a prospective and randomized controlled trial comparing contemporaneous transabdominal rigid ureteroscopy (TRU) with postoperative extracorporeal shockwave lithotripsy (SWL) in the management of migrated or residual stones during laparoscopic pyelolithotomy and ureterolithotomy in kidneys with either intrinsic or extrinsic abnormalities. Materials and Methods: From February 2016 to December 2019, 45 patients with migrated or residual stones following laparoscopic pyelolithotomy and ureterolithotomy were accrued and randomly divided into two groups. These patients all had either urinary tract obstruction distal to the stone or concomitant ipsilateral intrinsic or extrinsic pathology requiring laparoscopic intervention. Twenty-three patients underwent contemporaneous TRU, and 22 patients underwent postoperative SWL. Patients' demographics, perioperative variables, and follow-up data were collected. The primary outcome was the final stone-free rate (SFR) at the 2-month follow-up. Secondary outcomes included blood loss, operative time, change in serum creatinine, complications per Clavien-Dindo grading system, renal colic occurrence rate (RCOR), and postoperative hospitalization. Results: There was no significant difference in gender, age, body mass index, location, or stone burden between the two groups ( p > 0.05). At the 2-month follow-ups, the SFR was higher in the TRU than the SWL group ( p = 0.002), and the RCOR was lower in the TRU than the SWL gro...