Effect of 3D laparoscopic surgery for ureteral stricture.

Objective: To investigate the efficacy and safety of 3D laparoscopic surgery for ureteral stricture.

Methods: There were 47 patients with ureteral stricture and treated with 3D laparoscopic surgery from December 2017 to December 2020, and comprehensive analysis of relevant clinical data. Among the patients with ureteral stricture, there were 31 males and 16 females, 28 were left-sided and 19 were right-sided, aged 20-78 years, with an average age of 43 years; the number of upper and middle ureteral stricture cases was 34, and the lower ureteral stricture was 13, with a stricture length of 0.5-4.0 cm; all patients had different degrees of hydronephrosis before surgery, and the degree of separation of the renal collecting system before surgery was 36.19±4.09 mm. Preoperative serum creatinine was 82.00±35.49 μmol/L. Patients with upper and middle ureteral stricture underwent 3D laparoscopic ureteral stricture resection plus ureter end anastomosis, and patients with lower ureteral stricture underwent 3D laparoscopic ureteral bladder reimplantation.

Results: All patients had successful surgery, with an operative time of 132.87±27.64 min, an estimated intraoperative bleeding volume of 58.94±22.29 ml, a postoperative hospital stay of 7.81±1.74 days, and no complications such as intestinal injury and abdominal hemorrhage occurred; the ureteral stent tube was removed 8-12 weeks after the operation, and the follow-up was 3-36 months, with a mean of 18.98±11.36 months. The patients' hydronephrosis was reduced or disappeared, and the symptoms such as back pain and swelling were effectively relieved. The degree of separation of the renal collecting system was 15.28±3.26 mm and the creatinine value was 72.38±29.20 μmol/L on postoperative reexamination, which were statistically significant compared with those before surgery (P<0.05).

Conclusion: 3D laparoscopic ureteral stricture resection plus ureter end anastomosis or 3D laparoscopic ureteral bladder reimplantation for ureteral stricture is safe and effective, with few complications and rapid postoperative recovery.