经后腹腔径路行腹腔镜输尿管上段切开取石术

Retroperitoneal laparoscopic ureterolithotomy for upper ureter stones

目的探讨经后腹腔径路行腹腔镜输尿管上段切开取石术的临床经验。方法回顾分析经后腹腔径路行腹腔镜输尿管上段切开取石治疗输尿管上段结石28例的临床资料。结果28例手术均获成功,平均手术时间72min,术中平均出血35mL,随访25例12-24个月,无中远期并发症。结论建立在熟练腹腔镜操作技术的基础上和掌握好适应证,经后腹腔径路行腹腔镜输尿管上段切开取石治疗输尿管上段结石具有创伤小、治疗效果好等优点。在结石较大（1.5cm以上）、嵌顿、息肉包裹、输尿管迂曲、结石梗阻远端合并狭窄以及腔内手术失败等情况下考虑开放手术时,可以行腹腔镜手术代替开放手术。

Objective To investigate the clinic experience of retropertoneal laparoscopic ureterolithotomy for upper ureter stones. Methods Data of 28 cases treated by retroperitoneal laparoscopic ureterolithotomy were retrospectively reviewed. Results The stones in all patients were successfully removed in a median operating time of 72 rain utes,mean estimated blood loss of 35 ml,25 cases had been followed up for 12 -24 months, and no related postoperative complication. Conclusion With good retroperitoneal laparoscopic skill and strict grasping of indication, retroperitoneal laparoscopic ureterolithotomy is a useful,minimally invasive and effective therapy for upper ureter stones. It can take the place of traditional open surgery in some cases, especially in those of large upper ureter stones（ 〉 1.5 cm）, ureterostenosis under stones, ureter stones with severe adhesion or failed ESWL and/or URS.