腹腔镜输尿管切开取石术38例报告

Experience of laparoscopic ureterolithotomy:with a report of 38 cases

目的:探讨腹腔镜输尿管切开取石术的技巧。方法:2005年1月至2008年3月我院应用三套管技术为38例输尿管结石患者行腹腔镜输尿管切开取石术,其中左侧23例,右侧15例。结果:手术均获成功,手术时间85～320min,平均110min,出血50～80ml,术后住院4～7d,无尿漏。随访6～12个月无输尿管狭窄,肾功能改善。结论:结石准确定位,锐性切开输尿管,良好的双"J"管引流和镜下缝合打结技术是腹腔镜切开取石术成功的关键。

Objective ：To introduce the technique of laparoscopic ureterolithotomy. Methods： Thirty-eight cases of ureterolithiasis, of whom 23 cases had calculi on the left side and 15 cases on the right side, underwent laparoscopic ureterolithotomy through 3-port technique. Results：All the operations were successful, without complications such as urine leakage. The mean operative time was 110min （ranged 85 to 320min）. Blood loss was 50 to 80ml. The postoperative hospitalization was 4 to 7 days. During the follow-up of 6 to 12 months, no ureteral stricture was found. The renal functions were improved. Conclusions：Our experience indicates that exact checking of calculary location, sharp incision of ureter, patent drainage with double ＂J＂ tube and skillful intra-abdominal suturing are the keys to perform laparoscopic ureterolithotomy successfully.