后腹腔镜肾盂切开联合膀胱软镜碎石取石术8例报告

Retroperitoneal laparoscopic pyelolithotomy combined with flexible cystoscope lithotripsy:a report of 8 cases

目的：探讨后腹腔镜肾盂切开联合膀胱软镜碎石取石术的有效性、安全性及可行性。方法回顾分析2011年7月至2014年3月我院8例后腹腔镜肾盂切开联合膀胱软镜碎石取石术患者的临床资料。结果8例手术均成功，一期取石率为100％，平均手术时间（85.0±5．6）min，平均术中出血量（17.0±2．1）mL，术后平均住院天数（7.0±0．5）d，围手术期无明显并发症发生。术后复查腹平片未见结石残留，术后随访1～3月未发现吻合口狭窄，无继发肾结石形成。结论后腹腔镜肾盂切开联合膀胱软镜碎石取石术是安全可行的，是处理肾盂结石的一种“双镜联合”治疗的新术式，可作为经皮肾镜碎石术（PCNL）及设备欠缺单位的替代术式，但临床使用价值有待进一步求证。

Objective To investigate the efficacy ,safety and feasibility of retroperitoneal laparoscopic pyelolithotomy combined with flexible cystoscope lithotripsy .Methods The clinical data of 8 cases of retroperitoneal laparoscopic pyelolitho‐tomy combined with flexible cystoscope lithotripsy performed in our hospital during July 2011 to March 2014 were retrospec‐tively analyzed .Results All operations were successful .The first phase stone‐free rate was 100% ,average operative time （85.0 ± 5 .6）min ,average blood loss （17.0 ± 2 .1）mL ,mean postoperative hospital stay （7.0 ± 0 .5）d .No significant periopera‐tive complications occurred ,no residual stones were observed ,no anastomotic stricture or secondary kidney stones were found after 1‐3 months＇follow‐up .Conclusions Retroperitoneal laparoscopic pyelolithotomy combined with flexible cystoscope lithotripsy is a new ,safe and feasible surgical treatment of “combined laparoscopic‐endoscopic technique” for pelvis stones , which can be used as an alternative treatment of percutaneous nephrolithotomy lithotripsy （PCNL） in hospitals where surgical equipment are inadequate ,but the clinical value needs further confirmation .