后腹腔镜输尿管上段切开取石术(附12例报告)

Retroperitoneoscopic ureterolithotomy on patients with upper ureter stones

目的探讨后腹腔镜输尿管上段切开取石术技术要点和临床价值。方法采用后腹腔镜完成12例输尿管上段切开取石术,其中8例术前体外冲击波碎石术(ESWL),4例术前未行其它治疗,结石直径15～20mm,平均18mm。结果12例手术全部成功,手术时间60～250min,平均110min。术中出血20～80ml。术后住院时间5～6d。随访2～15个月,无并发症发生。结论后腹腔镜输尿管上段切开取石术具有组织损伤小,术后恢复快的特点,适用于ESWL、输尿管镜腔内碎石失败,结石大的病例。

Objective To evaluate the clinical role and technique of rertroperitoneoscopic ureterolithotomy. Methods Retroperitoneoscopic ureterolithotomy was performed in 12 eases with upper ureteral stones, and in 8 patients as a salvage procedure after unsuccessful ESWL, and in 4 patients as a primary procedure. The stone size ranged from 12mm to 22mm （mean 16mm）. Results All the 12 eases had successful surgery with time of 60-250min（mean 110min）, and blood loss of about 20-80ml. The hospital stays were 5-6 days after operation. All the patients fully recovered with no complication observed during the 9-12 months follow-up. Conclusions Retroperitoneoscopic ureterolithotomy has the advantages of less tissue injury and faster recovery, can be seasoned with the cases of large caculi and unsuccessful therapy with ESWL or introluminal detritus.