后腹腔镜输尿管切开取石术治疗输尿管上段嵌顿结石（附43例报告）

Retroperitoneal laparoscopic ureterolithotomy for impacted upper ureteric calculi

目的评估后腹腔镜输尿管切开取石术（RLU）治疗输尿管上段嵌顿结石的疗效并优化手术技巧。方法2008年1月至2011年6月，共43例输尿管上段嵌顿结石患者接受了标准的后腹腔镜输尿管切开取石术，术后随访12个月。结果成功取石41例，结石清除率95．35％，1例因黏连严重转开放切开取石术，1例结石上移后改行ESWL术碎石成功；手术时间平均65．7rain，术中出血量平均31．2mL，1例出现漏尿，术后无输尿管狭窄。结论RLU是治疗输尿管上段嵌顿结石安全有效的微创手术方法。

Objectives To assess the feasibility and optimize surgical skills of retroperitoneal laparoscopic ureterolithotomy in the treatment of impacted upper ureteric calculi. Methods From January 2008 to June 2011,43 patients with impacted upper ureteric calculi underwent standard retroperitoneal laparoscopic ureterolithotomy. All patients were followed -up for 12 months. Results The stone was successfully removed in 41 cases, the stone - free rate was 95.35% （41/43）. Open surgery was converted in one case for bad tissue adhesions. One patient was cured by ESWL after the stone was pushed back. The mean operation duration is 65.7 minutes, the mean intraopera- tive blood loss is 31.2 ml and prolonged urinary leakage was occurred in 1case. No ureteral stricture was found. Conclusions Retroperitoneal laparoscopic ureterolithotomy is a safe and reliable minimally invasive procedure for impacted upper ureteral calculi.