Laparoscopic Pyelolithotomy: Initial Experience with 62 Patients

Abstract

Objective: To evaluate the role of the laparoscopic approach in the management of pelvic calculi in a urology centre in Douala, Cameroon. Materials and Methods: This was a retrospective study carried out from 2014 to 2019 involving 62 patients with calculi at the renal pelvis managed through laparoscopic pyelolithotomy. Results: We recruited 62 patients (38 men and 24 women) with a median age of 36 [25 - 48] years. Nephritic colic was the most frequently encountered presenting complaint (92% of cases). In 56.45% of cases, the stone was on the left side of the body. Twelve patients had kidney acute failure at the time of diagnosis. Five patients received antibiotics for urinary tract infections before the operation. Before surgery, eight double J stents were placed in 8 patients; in five because of urinary tract infection and in three because of nephritic colic. In all the cases, the definitive diagnosis was made using abdominal CT scans. The median size of the calculi was 22 [17 - 28] mm. Dilatation of the pyelocaliceal cavity was noticed in all the patients. The median surgery duration was 100 [90 - 120] minutes. Drainage of the urinary tract using a double J stent was performed in all the patients, whereas percutaneous drainage was performed only in 9.67% of cases. There was no case of conversion to open surgery. Control ultrasound performed one month after the removal of the double J stent did not reveal any residual stones in the pyelocaliceal cavities. Conclusion: Laparoscopic pyelolithotomy is a mini-invasive technique that is adequate for the management of voluminous pelvic calculi.