Vol. 6, Issue 1, Part A (2024)

Background: Various techniques have been documented for the management of Large Proximal Ureteric Stones (LPUS), such as laparoscopy (LUL), antegrade approach, retrograde ureteroscopy (RURS), extracorporeal shockwave lithotripsy, and infrequently open surgery. The paper aimed to compare the overall results of treating patients with large proximal ureteric stones (15-20 mm) using transperitoneal LUL, RURS, and mini-percutaneous antegrade ureteroscopy.
Methods: This prospective, randomized trial involved 50 individuals of both sexes who were above the age of 18 and had a single, 15-20 mm LPUS. Patients were split into two equal groups at random: Group B received RURS combined with laser fragmentation, and Group A received LUL. 
Results: Regarding patient demographics and stone criteria, both groups were similar. Group A had a substantially greater stone-free percentage (100%) than Group B (72%). There was a significant difference (p<0.001) in the operating duration, hemoglobin deficit, and ultimate stone-free rate between groups A and B. There was little difference in the two groups' conversation rates, mucosal injuries, ureteral perforations, complications, and length of hospital stay. 
Conclusions: Compared to RURS, LUL is linked to a greater stone-free rate and fewer complications.