后腹腔镜下输尿管上段切开取石术的临床观察

The clinical observation of retroperitoneal laparoscopic upper ureteral incision

目的比较后腹腔镜下输尿管上段切开取石术与传统经腰切口开放性手术治疗输尿管上段结石的临床疗效。方法回顾性分析2012年1月-2015年9月蚌埠市第三人民医院收治45例输尿管上段结石患者的手术治疗资料，23例（A组）采用后腹腔镜下输尿管上段切开取石术治疗，22例（B组）采用传统经腰切口开放术式治疗。结果A组在术中出血量及术后胃肠功能恢复时间、住院日等观察指标上少于B组，差异有统计学意义（P〈0．05），A组的手术时间、手术费用高于B组，差异有统计学意义（P〈0．05）。A组术后2例应用镇痛药物，B组术后16例应用镇痛药物，A组少于B组，差异有统计学意义（P〈0．05）；两组手术的结石清除率均为100％，术后尿漏、输尿管狭窄发生率均为0。结论后腹腔镜下输尿管切开取石术治疗输尿管上段结石具有创伤小、出血少、术后疼痛轻、恢复快、疗效可靠，可作为微创手术替代开放手术，值得推广。

Objective Comparison analysis of the clinical efficacy of retroperitoneal laparoscopic treatment of upper ureteral calculi with open surgical treatment of upper ureteral calculi. Methods From January 2012 to September 2015, 45 cases of upper ureteral calculi in our hospital were treated with surgical treatment, and 23 cases （group A） were treated by retroperitoneal laparoscopic treatment, and 22 cases （group B） were treated by open surgery. Results The bleeding volume, postoperative gastrointestinal function recovery time, postoperative hospital stay of A group were less than that of B group, the difference was statistically significant （P 〈0.05）, the operation time and operation cost of A group was higher than that of B group, the difference was statistically significant （P〈 0.05）. In group A, two cases of analgesic drugs were applied, and 16 cases of analgesic drugs in group B, group A was less than group B, the difference was statistically significant （P 〈 0.05）; the removal rate of calculi in the two groups was 100%, the incidence rate of urinary leakage and ureteral stenosis was 0, no significant difference. Conclusion Retroperitoneal laparoscopic treatment of upper ureteral calculi with minimally invasive surgery, less trauma, less bleeding, postoperative pain, rapid recovery, reliable efficacy, can be used as a minimally invasive surgery. Key words：Retroperitoneal laparoscopy; Ureteral calculi; Minimally invasive surgery