后腹腔镜治疗输尿管上段结石35例报告

Retroperitoneal Laparoscopy for Upper Ureteral Calculi:Report of 35 Cases

目的探讨后腹腔镜输尿管上段切开取石术的可行性。方法采用后腹腔镜下输尿管切开取石术治疗输尿管上段结石35例。结果34例后腹腔镜下取石成功,1例因结石返回肾盂改开放手术。手术时间70~135min,平均110min。术中出血量20~55ml,平均36ml。无术后漏尿超过2d。术后2~3d拔除腹膜后引流管。术后住院时间6~10d,平均7.8d。术后1个月拔除双J管后B超复查,重度积水9例均较术前减轻,轻中度积水中17例消失、9例明显减轻。术后对于7例重度积水及11例轻中度积水进行2~6个月随访,B超复查均无结石复发,肾积水程度与术后1个月拔除双J管时无明显变化。结论后腹腔镜技术作为治疗输尿管上段结石可行,可作为开放手术或其他微创方法的替代或补充。

Objective To evaluate the feasibility of retroperitoneal laparoscopy for patients with upper ureteral calculi. Methods A total of 35 patients with upper ureteral calculi were treated with retroperitoneal laparoscopy. Results The operation was completed in all but one patient, who was converted to open surgery because the calculi moved into the renal pelvis. The operation time ranged from 70 to 135 minutes (mean, 110 minutes). Intraoperative blood loss was 20 to 55 ml (mean, 36 ml). No patient had over-2-day...