后腹腔镜输尿管上段切开取石术107例报道

Retroperitoneoscopic ureterolithotomy for treatment of upper segment ureteral calculi:report of 107 cases

目的探讨腹腔镜下切开取石治疗输尿管上段结石的临床疗效。方法回顾分析该院2004年6月至2009年6月107例输尿管上段结石采用后腹腔镜下输尿管切开取石术治疗的临床资料。结果 104例取石成功,3例术中结石移位中转开放手术。结论对较大(直径大于或等于1.5cm)的输尿管上段结石或直径1.0～1.5cm经体外冲击波碎石、输尿管镜下气压弹道碎石失败、积水轻行经皮肾穿刺碎石术困难的病例,后腹腔镜下输尿管切开取石具有一次性结石取尽率高、损伤小、恢复快、住院时间短等优点,是治疗输尿管上段结石的有效方法。

Objective To evaluate the clinical value and efficacy of retroperitoneoscopic ureterolithotomy for treating upper segment ureteral calculi.Methods From June 2003 to June 2009,retroperitoneoscopic upper ureterolithotomy was performed in 107 patients,and the data were analyzed retrospectively.Results The procedure was successfully accomplished in 104 cases,the remaining 3 cases were converted to open operation because of calculi migration.Conclusion For the patients with large calculus（≥1.5cm in diameter） or with calculus（1.0-1.5cm in diameter）,failed in the treatment by ESWL and ureteroscopic lithotripsy（URSL）,mild nephrohydrosis with difficulty of PCNL treatment,retroperitoneoscopic ureterolithotomy is a safe,effective procedure with the advantages of high stone removal rate,minimal invasion,good recovery and short hospital time.