后腹腔镜手术治疗嵌顿性输尿管上段结石的疗效观察

Therapeutic effect of retroperitoneal laparoscopic ureterolithotomy for impacted upper ureteral calculi

目的:探讨后腹腔镜输尿管切开取石术在治疗嵌顿性输尿管上段结石中的价值。方法:对21例后腹腔镜输尿管切开取石术(后腹腔镜组)和27例开放性输尿管切开取石术(开放手术组)治疗嵌顿性输尿管上段结石患者的临床资料进行分析。结果:48例手术均成功,无严重并发症。后腹腔镜组术中出血量、术后肠功能恢复、下床活动及住院时间均明显优于开放手术组(P<0.01),2组的手术时间和术后引流管、导尿管拔除时间比较差异无统计学意义(P>0.05)。结论:后腹腔镜输尿管切开取石术安全、微创、效果确切,可作为治疗嵌顿性输尿管上段结石的首选方法。

Objective：To evaluate the clinical value of retroperitoneal laparoscopic ureterolithotomy for the treatment of impacted upper ureteral calculi.Methods：The clinical data of 21 cases by retroperitoneal laparoscopic ureterolithotomy（retroperitoneal laparoscopic group） and 27 cases by open ureterolithotomy（open surgical group） for the treatment of impacted upper ureteral calculi were retrospectively analyzed and compared.Results：All the 48 cases were treated successfully with no serious complication.Compared with open surgical group,intraoperative blood loss,the time of intestinal functional recovery,out-of-bed action and hospital stay after operation were significantly better than those in retroperitoneal laparoscopic group（P0.01）,the time of operation,the time of drainage-tube and urinary catheter removed after operation had no significant difference between these two groups（P0.05）.Conclusions：Retroperitoneal laparoscopic ureterolithotomy is safe,minimally invasive and effective.It may be the first choice for treatment of impacted upper ureteral calculi.