A Report of Three Cases of Combined Dual-Scope Treatment for Ureteral Malformations Complicated by Renal Stones

Sun Yunji; Zhang Heng; Sun Xiaolu; Gao Yulan; Li Lihua; Sun Maokun

doi:10.19558/j.cnki.10-1020/r.2024.06.009

Abstract：Objective:To evaluate the clinical efficacy of laparoscopic surgery combined with choledochoscopy in the treatment of ureteral malformations complicated by renal stones.Methods:Between January 2022 and January 2023,three patients with ureteral malformations and renal stones were treated at the Department of Urology,Shan-dong Provincial Third Hospital Affiliated to Shandong University.Two patients had ureteropelvic junction obstruc-tion(UPJO)combined with renal stones,and one patient had a retrocaval ureter with renal stones.Laparoscopic sur-gery was used to treat the ureteral malformations,and choledochoscopy was employed for stone removal.Preopera-tive evaluations included assessing the length of the ureteral stricture.Intraoperatively,the renal pelvis and proximal ureter were incised,and the choledochoscopy was introduced through the renal pelvis incision to remove renal stones from the renal calyces.The renal pelvis-ureter junction was reconstructed and repaired.Results:All three surgeries were completed successfully without postoperative complications.The perinephric drainage tube was removed on the second postoperative day,the urinary catheter was removed one week postoperatively,and the double-J(D-J)stent was removed eight weeks after surgery.At six months post-removal,follow-up imaging showed no dilation of the re-nal pelvis or proximal ureter in any of the patients.Conclusion:Laparoscopic surgery combined with choledochosco-py is an efficient and safe treatment for ureteral malformations complicated by renal stones.It could serve as the pre-ferred surgical approach for this condition.However,further multicenter,large-sample,and long-term follow-up studies are needed to verify its long-term efficacy and safety.