Minimally Invasive Techniques for Treating Large Proximal Ureteral Stones

Tanta University

Status: Completed

Conditions: Endourology

Treatments: Procedure: transperitoneal laparoscopic ureterolithotomy (T-LUL)/ retrograde flexible ureteroscopy (R-URS) /Antegrade mini-percutaneous flexible ureteroscopy (A-URS)

Study type: Interventional

Funder types: Other

Identifiers

NCT06199518

34619/4/21

Details and patient eligibility

About

a prospective comparative study designed to compare the outcomes of transperitoneal Laparoscopic ureterolithotomy (T-LUL), mini-percutaneous antegrade ureteroscopy (A-URS) and retrograde ureteroscopy (R-URS) in treating patients with LPUS (15-20 mm). the following parameters were assessed and compared (demographic data and stones characteristics, Stone free rate and complications)

Full description

we aimed in the current study to comprehensively evaluate and to compare the outcome of transperitoneal laparoscopic ureterolithtomy, retrograde ureteroscopy and mini-percutaneous antegrade ureteroscopy for management of large proximal ureteric stone (15 -20 mm) with regards to; operative time, stone free rate, success rate, hospital stay and complications.

A total of 105 participants were enrolled in the trial between April 2021 and June 2023 to accomplish this. Inclusion criteria for this study included patients who had a single proximal Ureteral stone (between the pelvi ureteric junction and the upper border of the sacroiliac joint) measuring 15-20 mm in diameter.

Patients were randomly allocated to receive either TPLU, RURS, or Minin-perc Antegrade URS, with a 1:1:1 allocation ratio. After providing informed permission, the patients were randomly assigned to one of three groups: Group I (35 patients treated with TPLU), Group II (35 patients treated with RURS), and Group III (35 patients not treated with either TPLU or RURS) (Included 35 patients who were treated by Mini-perc Antegrade URS)

Enrollment: 105 patients

Sex: All

Ages: 26 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults patients
• large proximal ureteral stones(1.5-2 cm)

Exclusion criteria

• larger stones
• multiple stones
• bleeding tendency
• active UTI
• distal stricture

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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105 participants in 3 patient groups

GROUP(A):transperitoneal laparoscopic ureterolithotomy (T-LUL)

Active Comparator group

Description:

extraction of proximal ureteral stones by laparoscopic surgery via transperitoneal approach

Treatment:

Procedure: transperitoneal laparoscopic ureterolithotomy (T-LUL)/ retrograde flexible ureteroscopy (R-URS) /Antegrade mini-percutaneous flexible ureteroscopy (A-URS)

GROUP (B):retrograde flexible ureteroscopy (R-URS)

Active Comparator group

Description:

laser lithotripsy of proximal ureteral stones via flexible ureteroscopy retrograde

Treatment:

Procedure: transperitoneal laparoscopic ureterolithotomy (T-LUL)/ retrograde flexible ureteroscopy (R-URS) /Antegrade mini-percutaneous flexible ureteroscopy (A-URS)

GROUP (C):Antegrade mini-percutaneous flexible ureteroscopy (A-URS)

Active Comparator group

Description:

laser lithotripsy of proximal ureteral stones via percutanous antegrade flexible ureteroscopy

Treatment:

Procedure: transperitoneal laparoscopic ureterolithotomy (T-LUL)/ retrograde flexible ureteroscopy (R-URS) /Antegrade mini-percutaneous flexible ureteroscopy (A-URS)