后腹腔镜在肾盂及输尿管上段结石的临床应用:附43例报告

Clinical Application of Retroperitoneal Laparoscopic Ureterolithotomy for the Calculi of Renal Pelvis and Upper Ureter: 43 Cases Report

目的探讨后腹腔镜切开取石术治疗肾盂及输尿管上段结石的安全性、有效性及其适应证。方法回顾性分析2013年6月-2015年6月采用后腹腔镜切开取石治疗43例肾盂及输尿管结石患者的临床资料,其中肾外型肾盂结石9例,输尿管上段结石34例。结果本组43例患者手术取石均一次成功,手术时间60-180 min,平均（92.7±14.5）min,出血量10-50 ml,平均（19.4±5.5）ml。术后有2例曾行体外碎石的肾盂结石患者有少许碎石残留。所有患者术后2个月顺利拔除双J管,复查超声,肾积水程度较术前减轻1-3 cm,平均（1.8±0.5）cm。结论只要注意适应证的选择,后腹腔镜切开取石术治疗肾盂及输尿管上段结石是安全有效的处理方式。

Objective To evaluate the safety,efficacy and indications of retroperitoneal laparoscopic ureterolithotomy in the treatment of the renal pelvis and upper ureteral calculi. Method The clinical data of43 cases with renal pelvis and upper ureteral calculi treated by retroperitoneal laparoscopic ureterolithotomy admitted from June 2013 to June 2015 were analyzed retrospectively. Results The operations were accomplished successfully in all 43 patients. The operative duration was 60 to 180 minutes with an average of（ 92. 7± 14. 5） minutes,and the intraoperative blood loss was 10 to 50 ml with and average of（ 19. 4 ± 5. 5） ml. Two cases with pelvis calculi had ESWL history were found few residual stones. The double J tube was extubated successfully two months after the operation,and the hydronephrosis was improved obviously. Conclusion The surgical intervention of retroperitoneal laparoscopic ureterolithotomy is a safe and effective treatment for the calculi of renal pelvis and upper ureter based on suitable indications selection.