输尿管结石合并扭曲的输尿管镜手术技巧及失败原因分析与对策

Surgical technique and failure cause analysis and countermeasure of ureteral calculi complicated with twisted ureter mirror

目的 探讨输尿管镜碎石术治疗合并输尿管扭曲的输尿管结石的手术技巧,同时分析输尿管镜碎石取石手术失败的原因与进一步处理的对策.方法 回顾性分析2014年6月至2016年1月就诊的输尿管结石合并扭曲行输尿管镜碎石取石及失败后采用其他方式取石共计47例患者的临床资料.结果 47例患者中,29例通过调整体位、改进手术方法等方式,顺利完成手术,6例行经皮肾镜碎石术,10例行腹膜后腔镜下输尿管切开取石术,2例行开放取石术.结论 输尿管镜碎石术是治疗输尿管结石的有效方法,但合并输尿管扭曲时,手术难度增加,通过改进手术方法或调整手术方式,仍可达到取出结石、治愈疾病的治疗目的.

Objective To investigate the surgical techniques of ureteral calculi in the treatment of ureteral calculi with ureteral calculi, and to analyze the causes of failure and the countermeasures for further treatment.Methods The clinical data of 47 patients with ureteral calculi complicated with ureteral calculi and failure from June 2014 to January 2016 were analyzed retrospectively.Results In 47 patients, 29 cases through adjustment of the position, improving surgical technique etc.completed the operation successfully, 6 cases underwent percutaneous nephrolithotomy, 10 case underwent retroperitoneal laparoscopic ureter incision to take stone surgery, 2 cases with open stone surgery.Conclusions Ureteroscopic lithotripsy is an effective method in the treatment of ureteral calculi, but with ureter distortion, operation difficulty increases.By improving the surgical approaches or adjusting the operating mode, we can still reach out stones, cure disease.