M.R. Ben Slama

L’approche lomboscopique dans le traitement des calculs urétéraux lombaires

INTRODUCTION Retroperitoneal laparoscopy is a recent alternative to conventional surgical treatment of ureterolithiasis. The objective of this study was to evaluate the place of retroperitoneal laparoscopic ureterolithotomy. MATERIAL AND METHODS The authors report 50 cases of retroperitoneal laparoscopy for lumbar ureter stones performed in 49 patients between January 2001 and December 2006. The indications were a very large (>15 mm) obstructive stone in the lumbar ureter in 88% of cases, failure of extracorporeal shock wave lithotripsy (ESWL) in 6% of cases and refusal of ESWL in 6% of cases. RESULTS The mean stone diameter was 17 mm (range: 10-35 mm). The stone was removed by retroperitoneal laparoscopy in 46 out of 50 cases (92%). The mean operating time was 97 min. (range: 35-170 min.). The surgical conversion rate was 8%. Ten patients (20%) developed a urinary fistula requiring secondary drainage by double J ureteric stent. The mean hospital stay was 6.8 days. No cases of ureteric stenosis or kidney destruction was observed with a mean follow-up of 32 months. CONCLUSION Retroperitoneal laparoscopic lumbar ureterolithotomy is a safe, effective and minimally invasive technique which could constitute an alternative to open ureterolithotomy in the majority of its current indications.

Localisation iléale d’un carcinome à cellules rénales révélée par une invagination iléo-cæcale

The lung, the liver, the bone tissue and the brain are the most frequent sites for renal cell carcinoma metastasis. Small bowel metastasis from renal cell carcinoma is rare, with only few cases published. We report the case of ileal metastasis from operated kidney cancer revealed by ileocolic intussusception and causing intestinal obstruction in a 32-year-old woman.