Laparoscopy and ureteroscopy cooperative surgery for high burden stones in solitary kidney and ureter in one stage: A case report

Zhu,Kejia; Chang,Yao; Zhao,Delong; Guan,Yong; Ding,Sentai

doi:10.3892/etm.2023.11956

Laparoscopy and ureteroscopy cooperative surgery for high burden stones in solitary kidney and ureter in one stage: A case report

Authors:
- Kejia Zhu
- Yao Chang
- Delong Zhao
- Yong Guan
- Sentai Ding
View Affiliations

Affiliations: Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
Published online on: April 18, 2023 https://doi.org/10.3892/etm.2023.11956
Article Number: 257

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Treatment of kidney and ureter multiple calculi is a difficult procedure in urology. It is especially difficult to eliminate the high burden stones in a one‑stage operation. When a patient has had only one kidney since he/she was born (a condition termed ‘solitary kidney’), the conservation of the renal function is especially important. A series of combined surgery techniques have been developed, including endoscopic combined intrarenal surgery, extracorporeal shock wave lithotripsy sandwich therapy and laparoscopy‑assisted percutaneous nephrolithotomy, but not laparoscopy or endoscopy cooperative surgery. The present study described the case of a patient with a solitary kidney and ureter who developed multiple calculi. This condition led to hydronephrosis and severe anuria for 3 days. Urinary ultrasound indicated hydronephrosis of the left kidney and several stones were detected. The maximum renal stone was sized ~2.7x0.8 cm. In addition, a maximally sized stone of 2.9x0.9 cm was found in the left upper ureter. The patient had only one kidney, the right kidney was absent. Laboratory examinations revealed severe renal dysfunction. A percutaneous nephrostomy was immediately performed on the left kidney. Laparoscopy, flexible ureteroscopy, rigid ureteroscopy and ureteroscope pneumatic lithotripsy were used to eliminate all the stones in one stage. The patient recovered well and was discharged on the eighth day post‑surgery. The present case report highlighted that the conservation of kidney function is critical in the treatment of anuria lasting for 3 days in a patient with calculus. When the situation arises, laparoscopy combined with ureteroscopy cooperative surgery was shown to be a good choice for one‑stage clearance of complex stones in patients with a solitary kidney and ureter.

View Figures

View References

1	Liu Y, Chen Y, Liao B, Luo D, Wang K, Li H and Zeng G: Epidemiology of urolithiasis in Asia. Asian J Urol. 5:205–214. 2018.PubMed/NCBI View Article : Google Scholar
2	Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J and Lotan Y: Epidemiology of stone disease across the world. World J Urol. 35:1301–1320. 2017.PubMed/NCBI View Article : Google Scholar
3	Scoffone CM, Cracco CM, Cossu M, Grande S, Poggio M and Scarpa RM: Endoscopic combined intrarenal surgery in Galdakao-modified supine Valdivia position: A new standard for percutaneous nephrolithotomy? Eur Urol. 54:1393–1403. 2008.PubMed/NCBI View Article : Google Scholar
4	Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A, Straub M and Knoll T: EAU guidelines on interventional treatment for Urolithiasis. Eur Urol. 69:475–482. 2016.PubMed/NCBI View Article : Google Scholar
5	Hiki N, Yamamoto Y, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, Miki A, Ohyama S and Seto Y: Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection. Surg Endosc. 22:1729–1735. 2008.PubMed/NCBI View Article : Google Scholar
6	Fu W, Chen H, Ren C and Zhao J: Transabdominal laparoscopy and ureteroscopy one-stage surgery in the treatment of bilateral ureteropelvic junction obstruction combined with bilateral renal stones: A case report. Exp Ther Med. 24(450)2022.PubMed/NCBI View Article : Google Scholar
7	Salvado JA, Guzman S, Trucco CA and Parra CA: Laparoscopic pyelolithotomy: Optimizing surgical technique. J Endourol. 23:575–578. 2009.PubMed/NCBI View Article : Google Scholar
8	Onen A: Grading of hydronephrosis: An ongoing challenge. Front Pediatr. 8(458)2020.PubMed/NCBI View Article : Google Scholar
9	Hyams ES, Munver R, Bird VG, Uberoi J and Shah O: Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm: A multi-institutional experience. J Endourol. 24:1583–1588. 2010.PubMed/NCBI View Article : Google Scholar
10	Jiang K, Zhang P, Xu B, Luo G, Hu J, Zhu J and Sun F: Percutaneous nephrolithotomy vs. retrograde intrarenal surgery for renal stones larger than 2 cm in patients with a solitary kidney: A systematic review and a meta-analysis. Urol J. 17:442–448. 2020.PubMed/NCBI View Article : Google Scholar
11	Birowo P, Rasyid N, Atmoko W and Sutojo B: Case report: An occurrence of steinstrasse in retrograde intra renal surgery (RIRS) for large staghorn kidney stone: A difficult experience in managing surgical outcomes. F1000Res. 9(184)2020.PubMed/NCBI View Article : Google Scholar
12	Grosso AA, Sessa F, Campi R, Viola L, Polverino P, Crisci A, Salvi M, Liatsikos E, Feu OA, Maida FD, et al: Intraoperative and postoperative surgical complications after ureteroscopy, retrograde intrarenal surgery, and percutaneous nephrolithotomy: A systematic review. Minerva Urol Nephrol. 73:309–332. 2021.PubMed/NCBI View Article : Google Scholar
13	Hamamoto S, Yasui T, Okada A, Taguchi K, Kawai N, Ando R, Mizuno K, Kubota Y, Kamiya H, Tozawa K and Kohri K: Endoscopic combined intrarenal surgery for large calculi: Simultaneous use of flexible ureteroscopy and mini-percutaneous nephrolithotomy overcomes the disadvantageous of percutaneous nephrolithotomy monotherapy. J Endourol. 28:28–33. 2014.PubMed/NCBI View Article : Google Scholar
14	Ibarluzea G, Scoffone CM, Cracco CM, Poggio M, Porpiglia F, Terrone C, Astobieta A, Camargo I, Gamarra M, Tempia A, et al: Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access. BJU Int. 100:233–236. 2007.PubMed/NCBI View Article : Google Scholar
15	Streem SB and Geisinger MA: Combination therapy for staghorn calculi in solitary kidneys: Functional results with long-term followup. J Urol. 149:449–452. 1993.PubMed/NCBI View Article : Google Scholar
16	Diri A and Diri B: Management of staghorn renal stones. Ren Fail. 40:357–362. 2018.PubMed/NCBI View Article : Google Scholar
17	Merhej S, Jabbour M, Samaha E, Chalouhi E, Moukarzel M, Khour R and Chaiban R: Treatment of staghorn calculi by percutaneous nephrolithotomy and SWL: The hotel Dieu de France experience. J Endourol. 12:5–8. 1998.PubMed/NCBI View Article : Google Scholar
18	Soylemez H, Penbegul N, Utangac MM, Dede O, Çakmakçı S and Hatipoglu NK: Laparoscopy assisted percutaneous stone surgery can be performed in multiple ways for pelvic ectopic kidneys. Urolithiasis. 44:345–352. 2016.PubMed/NCBI View Article : Google Scholar
19	Haghighi R, Razi A, Haghighi A, Ebrahimipour N and Teimouri A: Laparoscopy-assisted transperitoneal percutaneous nephrolithotomy for the treatment of renal stones in a horseshoe kidney. Res Rep Urol. 12:49–52. 2020.PubMed/NCBI View Article : Google Scholar
20	El-Kappany HA, El-Nahas AR, Shoma AM, El-Tabey NA, Eraky I and El-Kenawy MR: Combination of laparoscopy and nephroscopy for treatment of stones in pelvic ectopic kidneys. J Endourol. 21:1131–1136. 2007.PubMed/NCBI View Article : Google Scholar