Current Indications for Open Stone Surgery in the Fully Equipped Stone Center

Kim, Yong Woo; Kim, Dong Sun; Yoon, Duck Ki; Cho, Jae Heung

Abstract

We retrospectively reviewed 913 stone treatment cases except the cases of spontaneous passage from March in 1992 to February in 1995. The operations performed for urinary stone consisted of 42 ureterolithotomies, 3 pyelolithotomies, 17 PNLs, 67 URS. The others of 762 cases were treated by extracorporeal shockwave lithotripsy (ESWL). .Forty-five open surgery were performed among 913 stone treatment procedures (4.9%). The indications of open surgery for lower ureteral stone included failed URS with and without prior ESWL and abnormalities limiting endoscopic access. Anatomic factors that required open surgery included duplicating system with ureterocele and duplicating system with ureteral polyp. The indications of open surgery for upper ureteral and ureteropelvic junction stone included failed ESWL, desire for one session success (short treatment time available by patient), poor economics for ESWL, unrelieved intractable pain, bilateral ureteral stone with anuria, suspicious malignancy, stone combined with ureteral stricture below. Open stone surgery has become more complex procedure. Patients undergoing open surgery, were usually combined by anomalies or obstruction requiring surgical correction, suspicious cancer or no definite preoperative diagnosis, need to relieve obstruction as soon as possible, the cases picked up by patient for their preference. We think the open surgery still can offer more benefit to the patient with above listing conditions.