Rol de la cirugía laparoscópica en el manejo de la litiasis urinaria en la era de la endourología en México

Autores/as

DOI:

https://doi.org/10.48193/zc2x9531

Palabras clave:

Pielolitotomía, ureterolitotomía, laparoscopía, litiasis

Resumen

Objetivo: El objetivo del estudio es describir los resultados de la serie de pielolitotomías y ureterolitotomías laparoscópicas del Hospital General de México.

Material y métodos: Análisis retrospectivo de pacientes operados de pielolitotomía y ureterolitotomía laparoscópica entre 2013 y 2022. Se analizaron el tamaño del lito, sangrado, tiempo quirúrgico, complicaciones, estancia intrahospitalaria, tiempo a retiro de catéter doble J y complicaciones.

Resultados: Fueron 46 pielolitotomías y 29 ureterolitotomías. 54% fueron hombres, con una media de edad de 45 años. Los resultados de las pielolitotomías fueron: medidas promedio de los litos fueron de 24x20mm con 1034 UH y un puntaje STONE promedio de 6; tiempo quirúrgico promedio de 124 min, sangrado promedio de 72ml, con estancia promedio de 2.3 días. Las ureterolitotomías mostraron una medida promedio de los litos fue de 22x11mm con 980 UH; tiempo quirúrgico promedio de 101min, sangrado promedio de 31ml, con estancia promedio de 2.4 días.

Conclusión: En litos únicos, de gran volumen (>20mm), tanto en uréter como pelvis renal, la cirugía laparoscópica puede ser una alternativa factible y reproducible al manejo endourológico con buenos resultados.

Referencias

Rukin NJ, Siddiqui ZA, Chedgy ECP, Somani BK. Trends in Upper Tract Stone Disease in England: Evidence from the Hospital Episodes Statistics Database. Urologia Internationalis. 2017;98(4): 391–396. https://doi.org/10.1159/000449510.

Curhan GC. Epidemiology of Stone Disease. The Urologic clinics of North America. 2007;34(3): 287–293. https://doi.org/10.1016/j.ucl.2007.04.003.

Ortegón-Gallareta R, Aguilar-Moreno J, Álvarez-Baeza A, Méndez-Domínguez N, Pech-Cervantes PI. Perfil epidemiológico de las hospitalizaciones por urolitiasis en el Estado de Yucatán, México. Revista Mexicana de Urología. 2019;79(5): 1–11. https://doi.org/10.48193/revistamexicanadeurologa.v79i5.517.

Shah J, Whitfield HN. Urolithiasis through the ages. BJU international. 2002;89(8): 801–810. https://doi.org/10.1046/j.1464-410x.2002.02769.x.

Jones P, Elmussareh M, Aboumarzouk OM, Mucksavage P, Somani BK. Role of Minimally Invasive (Micro and Ultra-mini) PCNL for Adult Urinary Stone Disease in the Modern Era: Evidence from a Systematic Review. Current Urology Reports. 2018;19(4): 27. https://doi.org/10.1007/s11934-018-0764-5.

Ng ACF, Wong MYC, Isotani S, Practical Management of Urinary Stone. Singapore: Springer; 2021. https://doi.org/10.1007/978-981-16-4193-0.

European Association of Urology. EAU Guidelines on Urolithiasis. 2022 https://uroweb.org/guidelines/urolithiasis

American Urological Association. Kidney Stones: Surgical Management Guideline. 2022

Doizi S, Traxer O. Flexible ureteroscopy: technique, tips and tricks. Urolithiasis. 2018;46(1): 47–58. https://doi.org/10.1007/s00240-017-1030-x

Proietti S, Rodríguez-Socarrás ME, Eisner B, De Coninck V, Sofer M, Saitta G, et al. Supine percutaneous nephrolithotomy: tips and tricks. Translational Andrology and Urology. 2019;8(Suppl 4): S381–S388. https://doi.org/10.21037/tau.2019.07.09.

Bayne DB, Chi TL. Assessing Cost-Effectiveness of New Technologies in Stone Management. The Urologic Clinics of North America. 2019;46(2): 303–313. https://doi.org/10.1016/j.ucl.2018.12.011.

Yadav R, Kumar R, Hemal AK. Laparoscopy in the management of stone disease of urinary tract. Journal of Minimal Access Surgery. 2005;1(4): 173–180. https://doi.org/10.4103/0972-9941.19264.

Hejj R, McNulty M, Calleary JG, Hejj R, McNulty M, Calleary JG. Urology: The Home of Endoscopy. In: Advances in Endoscopic Surgery. IntechOpen; 2011. https://doi.org/10.5772/24729.

Al-Awadi K, Kehinde EO, Al-Hunayan A, Al-Khayat A. Iatrogenic ureteric injuries: incidence, aetiological factors and the effect of early management on subsequent outcome. International Urology and Nephrology. 2005;37(2): 235–241. https://doi.org/10.1007/s11255-004-7970-4

de la Rosette J, Denstedt J, Geavlete P, Keeley F, Matsuda T, Pearle M, et al. The clinical research office of the endourological society ureteroscopy global study: indications, complications, and outcomes in 11,885 patients. Journal of Endourology. 2014;28(2): 131–139. https://doi.org/10.1089/end.2013.0436.

de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, et al. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. Journal of Endourology. 2011;25(1): 11–17. https://doi.org/10.1089/end.2010.0424.

Simforoosh N, Aminsharifi A. Laparoscopic management in stone disease. Current Opinion in Urology. 2013;23(2): 169–174. https://doi.org/10.1097/MOU.0b013e32835d307f.

Hassan Y, Rather AA, Bashir A, Wani IA, Rasool H. Comparative Study of Laparoscopic and Open Pyelolithotomy in the Management of Large Renal Pelvic Stones. Ibnosina Journal of Medicine and Biomedical Sciences. 2022;14: 022–027. https://doi.org/10.1055/s-0042-1749143.

Hamid CA, Ankur S, Sathish R. Laparoscopic management of urinary tract calculi: uncommon but effective alternative to open surgery in certain situations. International Archives of Integrated Medicine. 2019;6(5)

Bai Y, Tang Y, Deng L, Wang X, Yang Y, Wang J, et al. Management of large renal stones: laparoscopic pyelolithotomy versus percutaneous nephrolithotomy. BMC urology. 2017;17(1): 75. https://doi.org/10.1186/s12894-017-0266-7

Kusuma Duarsa GW, Wisnu Tirtayasa PM, Pramana IBP, Yudiana IW, Santosa KB, Oka AAG. Meta-Analysis of Laparoscopic Pyelolithotomy versus Percutaneous Nephrolithotomy as a Treatment of Large Kidney Stones. Open Access Macedonian Journal of Medical Sciences. 2022;10(F): 113–121. https://doi.org/10.3889/oamjms.2022.8122.

Wu T, Duan X, Chen S, Yang X, Tang T, Cui S. Ureteroscopic Lithotripsy versus Laparoscopic Ureterolithotomy or Percutaneous Nephrolithotomy in the Management of Large Proximal Ureteral Stones: A Systematic Review and Meta-Analysis. Urologia Internationalis. 2017;99(3): 308–319. https://doi.org/10.1159/000471773.

Choi JD, Seo SI, Kwon J, Kim BS. Laparoscopic Ureterolithotomy vs Ureteroscopic Lithotripsy for Large Ureteral Stones. JSLS : Journal of the Society of Laparoendoscopic Surgeons. 2019;23(2): e2019.00008. https://doi.org/10.4293/JSLS.2019.00008

Güler Y, Erbin A. Comparative evaluation of retrograde intrarenal surgery, antegrade ureterorenoscopy and laparoscopic ureterolithotomy in the treatment of impacted proximal ureteral stones larger than 1.5 cm. Central European Journal of Urology. 2021;74(1): 57–63. https://doi.org/10.5173/ceju.2021.0174.R1.

Lai S, Jiao B, Diao T, Seery S, Hu M, Wang M, et al. Optimal management of large proximal ureteral stones (>10 mm): A systematic review and meta-analysis of 12 randomized controlled trials. International Journal of Surgery. 2020;80: 205–217. https://doi.org/10.1016/j.ijsu.2020.06.025.

Descargas

Publicado

2024-09-19

Número

Sección

Artículos originales