输尿管上段结石3种微创术式的比较

Comparison of three minimally invasive surgical treatments for upper ureteral calculi

目的比较输尿管上段结石3种微创术式的有效性和安全性。方法回顾性分析使用输尿管镜、经皮肾镜以及后腹腔镜治疗输尿管上段结石患者576例的临床资料,其中接受输尿管镜取石术(URL)92例,经皮肾镜取石术(MPCNL)406例,后腹腔镜取石术(RLU)78例。结果URL成功率为58.5%,余下41.5%中转MPCNL;经皮肾镜成功率为100%;后腹腔镜手术成功率亦为100%。结论微创手术治疗输尿管上段结石安全有效,输尿管上段结石首选经皮肾镜及后腹腔镜取石术。

[ Objective ] To compare the efficacy and safety of three minimally invasive surgeries for the treatment of upper ureteral calculi so as to provide correct therapeutic regimen for clinician. [Methods] The clinical data were reviewed in 576 cases of upper ureteral calculi. Of all the patients, 92 cases were treated with ureteroscopic lithotripsy （URL）, 406 cases with pereutaneous nephrolithotomy and 78 cases with retroperitoneal laparoscopic ureterotomy （RLU）. [Results] The success rate of URL was 58.5% with the rest 41.5% converted to mPCNL, while the success rates of percutaneous nephrolithotomy and RLU were all 100%. [ Conclusion ] Minimally invasive surgeries for upper ureteral calculi are safe and effective, Pereutaneous nephrolithotomy and RLU are preferred for the treatment of upper ureteral calculi.