Laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral obstruction after failed endoscopic intervention: A technical report
Zhixiang Wanga, Bing Liua, Xiaofeng Gaob, Yi Baoa, Yang Wangb, Huamao Yeb, Yinghao Sunb, Linhui Wanga
a Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China; b Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China
Laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral obstruction after failed endoscopic intervention: A technical report
Zhixiang Wanga, Bing Liua, Xiaofeng Gaob, Yi Baoa, Yang Wangb, Huamao Yeb, Yinghao Sunb, Linhui Wanga
a Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China; b Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China
摘要 Objective: Complex ureteral obstruction is refractory to conventional urological intervention. This report describes a case of laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral obstruction. Methods: Right-side multiple ureteral stones and complicating ureteral obstruction failed an initial attempt of ureteroscopy lithotripsy with simultaneous percutaneous nephroscopy in a 23-year-old male. Laparoscopic ureterolysis with ureteroscopy and percutaneous nephroscopy was used simultaneously to dissect the periureteral adhesions with the patient placed in the Galdakao-modified supine Valdivia position. The ureter was incised to allow the insertion of a ureteral catheter through the twisted ureter, and a guide wire was advanced into the pelvis using ureteroscopy. A double-J stent was placed into the right-side ureter using antegrade percutaneous nephroscopy. Results: The laparoendoscopic procedure lasted 330 min with an estimated bleeding volume of 100 mL. The patient underwent an uneventful postoperative course, and postoperative followup radiography confirmed good positioning of the double-J stent. The double-J stent was removed 3 months after operation. The patient remained asymptomatic within a 13-month follow-up period.
Abstract: Objective: Complex ureteral obstruction is refractory to conventional urological intervention. This report describes a case of laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral obstruction. Methods: Right-side multiple ureteral stones and complicating ureteral obstruction failed an initial attempt of ureteroscopy lithotripsy with simultaneous percutaneous nephroscopy in a 23-year-old male. Laparoscopic ureterolysis with ureteroscopy and percutaneous nephroscopy was used simultaneously to dissect the periureteral adhesions with the patient placed in the Galdakao-modified supine Valdivia position. The ureter was incised to allow the insertion of a ureteral catheter through the twisted ureter, and a guide wire was advanced into the pelvis using ureteroscopy. A double-J stent was placed into the right-side ureter using antegrade percutaneous nephroscopy. Results: The laparoendoscopic procedure lasted 330 min with an estimated bleeding volume of 100 mL. The patient underwent an uneventful postoperative course, and postoperative followup radiography confirmed good positioning of the double-J stent. The double-J stent was removed 3 months after operation. The patient remained asymptomatic within a 13-month follow-up period.
基金资助: This study was supported by grants from the Shanghai Municipal Hospitals' Project for Emerging and Frontier Technology (No. SHDC12010115), Chinese Military Major Project for Clinical High-tech and Innovative Technology (No. 2010gxjs057), and the Project for the Key Discipline of Shanghai (No. 2013046).
通讯作者:
Linhui Wang
E-mail: wlhui@medmail.com.cn
引用本文:
Zhixiang Wang, Bing Liu, Xiaofeng Gao, Yi Bao, Yang Wang, Huamao Ye, Yinghao Sun, Linhui Wang. Laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral obstruction after failed endoscopic intervention: A technical report[J]. Asian Journal of Urology, 2015, 2(4): 238-243.
Zhixiang Wang, Bing Liu, Xiaofeng Gao, Yi Bao, Yang Wang, Huamao Ye, Yinghao Sun, Linhui Wang. Laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral obstruction after failed endoscopic intervention: A technical report. Asian Journal of Urology, 2015, 2(4): 238-243.
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