الفهرس 
ANATOMYOnly 14 pages are availabe for public view
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Abstract
T
he optimal treatment for ureteral calculi must consider many factors, including stone composition, location and size, patient characteristics, technical skills of the surgeon, and instrument availability.
Aim of the Work is to to assess the result of ureteroscopic lithotripsy using holmium laser with laparoscopic ureterolithotomy in the management of proximal ureteral stones larger than 10mm.
80 patients with upper ureteral stone more than 10 mm were randomly divided into two groups: one group underwent ureteroscopic holmium laser lithotripsy, and another group underwent laparoscopic ureterolithotomy. Operating time, postoperative hospitalization time, stone clearance rate and perioperative complications were compared.
We found Operation was successfully performed in all 80 cases, and no open surgery was converted in any case. In the ureteroscopy and laparoscopy groups, the mean operating time was 33.83 ± 6.39 min and 107.25 ± 20.13 min, respectively, their hospitalization time was 1.65 ± 0.48 days vs. 3.90 ± 0.63days, and stone clearance rate was 88.00% (32/40) vs. 95% (38/40), and residual stones were removed by extracorporeal shock-wave lithotripsy (ESWL). All patients were followed up for more than three months, and no major complications occurred.
We concluded that Laparoscopic ureterolithotomy and ureteroscopy are both effective and reliable for the treatment of proximal ureteral stones. However, considering the shorter operation and hospitalization times we suggest that ureteroscopy, as a minimally invasive method, may be the first choice in the treatment of proximal ureteral stones.