微创经皮肾镜碎石术和后腹腔镜输尿管切开取石术治疗复杂性输尿管上段结石的疗效比较

Comparison analysis of the effect between mini invasive percutaneous nephrolithotomy and retroperitoneal laparoscopic ureterolithotomy in the treatment of complex ureteral calculi

目的:比较微创经皮肾镜碎石术(MPCNL)和后腹腔镜输尿管切开取石术(RLU)治疗复杂性输尿管上段结石的疗效。方法:回顾性分析2011年5月至2015年5月收治的复杂性输尿管上段结石142例,根据所行术式分为MPCNL组和RLU组,比较2种术式的临床疗效与安全性。结果:RLU组住院时间、手术时间均明显少于MPCNL组(P<0.01),术后3 d净石例数多于MPCNL组(P<0.05);而2组D-J管留置时间、术后1个月净石例数、术后并发症发生率及住院费用差异均无统计学意义(P>0.05)。结论:MPCNL和RLU治疗复杂性输尿管上段结石疗效确切,RLU具有术后恢复快、短期净石率高等优势,值得临床推广应用。

Objective： To compare the effects between mini invasive percutaneous nephrolithotomy （MPCNL） and retroperitoneal laparoscopic ureterolithotomy（RLU） in the treatment of complex ureteral calculi. Methods：The clinical data in 142 patients with the complex ureteral calculi were retrospectively analyzed from May 2011 to May 2015. The patients were divided into the MPCNL group and RLU group according to the surgical method. The clinical efficacy and safety between two groups were compared. Results：The hospital stay, operative time and stone-free cases at postoperative 3 days in RLU group were significantly less than those in MPCNL group（P 〈 0. 01 to P 〈 0. 05 ）. The differences of D-J indwelling time, stone-free cases at postoperative 1 month, incidence of postoperative complications and hospitalization cost between two groups were not statistically significant （P 〉 0.05 ）. Conclusions：The effects of MPCNL and RLU in the treatment of complex ureteral calculi are good. The RLU is quick recovery and high stone-free, which is worthy of further clinical application.