Comparison of the Clinical Results and Complications of Retroperitoneal Laparoscopic Surgery with Open Surgery in the Renal Pelvis and Ureter Stones Alireza Farshi 1* , Rasoul Jafari 1 , Mohsen Amjadi 1 , Sakineh Hajebrahimi 2 , Mona Mohiti Asli 3 1 Department of Urology, Tabriz University of Medical Sciences, Tabriz, Iran 2 Iranian Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran 3 Students' Research Committee, Tabriz University of Medical Science, Tabriz, Iran ABSTRACT Purpose: The proper management of ureteral stones is essential due to the severity of symptoms and resulting kidney damage. Less invasive techniques such as ureteroscopy, shock wave lithotripsy, and percutaneous renal surgery have been proposed for the treatment of ureteral stones; however, they cannot entirely replace open surgery in patients with hard, large, prolonged, and impacted ureteral calculi. Recently, the use of laparoscopy in the treatment of ureteral stones has been considered. This study aimed to compare the clinical results and complications of retroperitoneal laparoscopic ureterolithotomy with open surgery in the renal pelvis and ureter stones. Materials and Methods: In this clinical trial, 70 patients with ureter and pelvic stones referred to Imam Reza Hospital of Tabriz University of Medical Sciences were enrolled and divided into two groups (n=35 each) based on their desire. Patients in the first group underwent laparoscopic retroperitoneal surgery, and in the second group underwent open stone surgery. Age, sex, size and location of the stone, recovery, need for re-intervention, duration of surgery, and complications in both surgical methods were compared. Results: Stones were successfully removed in all patients (100%) of the study groups. However, the incidence of postoperative complications in the retroperitoneal laparoscopic group was significantly lower than that of the open surgical group (p=0.023), wherein the retroperitoneal laparoscopic group, 29 (82.9%) patients, and in the open surgical group, 17 (48.6%) patients had no complications due to surgery. Conclusion: Retroperitoneal laparoscopic ureterolithotomy of the renal pelvis and ureter stones is an effective method without complications and can be used as an alternative to open surgery. Key words: Ureteral stone, Pelvis stone, Retroperitoneal laparoscopy, Open surgery HOW TO CITE THIS ARTICLE: Alireza Farshi, Rasoul Jafari, Mohsen Amjadi, Sakineh Hajebrahimi, Mona Mohiti Asli, Comparison of the clinical results and complications of retroperitoneal laparoscopic surgery with open surgery in the renal pelvis and ureter stones, J Res Med Dent Sci, 2019, 7(1): 211-215 Corresponding authors: Alireza Farshi e-mail✉: sciencegroup1988@gmail.com Received: 18/08/2018 Accepted: 22/02/2019 INTRODUCTION Urinary stones are the third most-commonly-reported problem in the urinary and genital tract after urinary tract infections and prostate diseases. Ureteral stones are more important than the stones of any other locations in the urinary system due to the severity of the symptoms and also the probability of the destruction of the kidney parenchyma [1]. Although the distal ureter stones can pass through the ureter to the bladder, it takes 2 to 3 weeks for large proximal ureteric stones (more than 10 mm) to reach the bladder and, in a worst case scenario, these stones compact and require surgical intervention [2,3]. In general, there are five therapeutic options for ureteral stones removal: extracorporeal shock-wave lithotripsy (ESWL), uteroscopic interventions, Laparoscopic nephrolithotomy (PNL), Laparoscopic ureterolithotomy (LUL) and Open Surgery (OSS) [4]. Although many ureteric stones can be easily managed by ESWL or ureteroscopy, some stones are resistant to these methods, and in developing countries, open surgical procedures are used due to their low cost and effectiveness [5]. Indications of surgical intervention for the removal of kidney stone include: Stones growth, Occlusion, Infection, Stones with severe symptoms, Stones larger than 15 mm, Preference of the patient, and Comorbidity [6]. The success rate of open surgery is as high as 97%, however, it has a more extended hospital stay and more postoperative Journal of Research in Medical and Dental Science 2019, Volume 7, Issue 1, Page No: 211-215 Copyright CC BY-NC 4.0 Available Online at: www.jrmds.in eISSN No.2347-2367: pISSN No.2347-2545 JRMDS J o u r n a l o f R e s e a r c h i n M e d i c a l a n d D e n t a l S c i e n c e Journal of Research in Medical and Dental Science | Vol. 7 | Issue 1 | February 2019 211