后腹腔镜下输尿管上段切开取石术中应用医用吻合胶12例报道

Adhere Ureter by Cyanoacrylate Tissue Glue in Retroperitoneal Laparoscopic Ureterolithotomy: Report of 12 Cases

目的：探讨后腹腔镜输尿管切开取石术中应用医用吻合胶吻合输尿管切口的安全性和疗效。方法：回顾性分析本院4年来经后腹腔镜下输尿管切开取石术12例患者临床资料。其中男7例，女5例；年龄26~64岁，平均（47.6±7.8）岁；均为单侧结石，其中左侧7例，右侧5例，结石直径15~25 mm；均经超声、IVU、CTU等明确诊断，均合并患肾中~重度积水；所有病例术中均留置双J管，以508医用吻合胶（OB型）粘合输尿管切口。结果：12例手术全部成功。手术时间30~240 min，平均（56.5±15.5）min；输尿管吻合时间5~11 min，平均（7±2.5）min。术后拔出腹膜后引流管时间2~3 d，平均（2.6±0.3）d；住院时间4~7 d，平均（5.6±0.7）d。随访时间1个月~3年，平均（1.3±0.6）年，无并发症发生。结论：后腹腔镜下输尿管切开取石术中应用医用吻合胶吻合输尿管切口安全性高、效果好，值得在临床推广。

Objective：To investigate the efficacy and safety of adhereing ureter by cyanoacrylate tissue glue in retroperitoneal laparoscopic ureterolithotomy. Method：12 cases with upper ureteral calculus were reviewed retrospectively undergoing retroperitoneal laparoscopic ureterolithotomy in our hospital in recent 4 years,and 7 were male,5 female. Age ranged from 26 to 64 years with a mean of（47.6±7.8）years. All were unilateral,and 7 were left,5 right. The diameter ranged from 15 to 25 millimeters. The ureteral stones were confirmed by ultrosonic examinations or/and IVU or/and CT scaning. All patients were treated with double J stent as internal stent and drainage,adhere ureter by cyanoacrylate tissue glue（508,OB）. Result：The operation was successfully completed in 12 cases. The operation time was from 30 to 240 minutes with a mean of（56.5±15.5）minutes. The time of adhereing ureter was from 5 to 11 minutes with a mean of（7±2.5）minutes. The time of extracting Retroperitoneal drainage tube was from 2-3 days with a mean of（2.6±0.3） days. The postoperative hospitalization was from 4 to 7 days with a mean of（5.6±0.7）days. Postoperative recovery was uneventful. No complication was observed during a follow-up of 1-36 months with a mean of（16±7）months. Conclusion：Adhere ureter by cyanoacrylate tissue glue in retroperitoneal laparoscopic ureterolithotomy is an ideally alternative procedure for upper ureteral stone with good safety and efficacy.