后腹腔镜手术治疗输尿管上段结石

The treatment of upper ureteral calculi with retroperitoneal laparoscopic ureterolithotomy

目的探讨后腹腔镜输尿管切开取石术的方法和临床价值。方法采用后腹腔镜技术行输尿管切开取石术共25例,均为输尿管上段结石,结石最大为25mm,最小为12mm,25例均有不同程度的肾积水。结果所有患者均一次手术成功,无一例中转开放手术。手术时间70～180min,平均90min。术中出血30～60ml,平均40ml。术后无明显并发症,术后住院时间6～9d。术后随访6～12个月,所有患者肾积水均有不同程度减轻,无明显输尿管狭窄。结论后腹腔镜输尿管切开取石术具有微创、出血少、术后恢复快等优点,可作为输尿管上段结石治疗的一种较佳的方法。

Objective To investigate the clinical significance and methods of retroperitoneal laparoscopic ureterolithotomy.Methods Retroperitoneal laparoscopic ureteroljthotomy was performed on 25 patients with upper ureteral stone,the stone size ranging from 1.2-2.5 cm in diameter.Hydronephrosis existed in all the patients.Results All 25 cases succeeded in first time.The mean operation time was 90 minutes（70-180 min）,and the estimated blood loss was 30-60 ml with a mean of 40 ml.The postoperative hospital stay was 6-9 d.There was no serious complications in perioperative and postoperative period.During the 6-12 months＇ follow-up,the patients＇ renal function had been improved with no ureteric stricture.Conclousion Retroperitoneal laparoscopic ureterolithotomy has the advantages of minimal invasion,safe,effective and quicker recovery.It can used as a good method in treating upper ureteral calculi.