后腹腔镜下输尿管中上段切开取石50例报告

Retroperitoneoscopic Ureterolithotomy on Patients with Midupper Segment of Ureter Stones: A report of 50 Cases

目的探讨后腹腔镜下输尿管中上段切开取石的操作要点和经验。方法 2015年5月~2016年5月对术前经B超、腹部平片、静脉泌尿系造影或CT确诊为输尿管中上段结石患者50例,采用后腹腔镜行输尿管切开取石,患者术前均有体外冲击波碎石或输尿管镜碎石治疗失败史,结石直径0.8~2.5 cm。结果 50例均获成功,手术时间25~73 m in,平均48min;术中出血量5~40 ml,平均20ml;平均6个月后随访,未发现结石残余、结石复发、输尿管狭窄及肾积液等并发症。结论后腹腔镜输尿管切开取石治疗输尿管中上段结石是安全有效的手术方式。

Objective:To study the main operative points of retroperitoneoscopic ureterolithotomy on patients with mid-upper segment of ureter stones.Methods:In total,50 patients with mid-upper segment of ureter stones who underwent retroperitoneoscopic ureterolithotomy after failure of extracorporeal shock-wave lithotripsy(ESWL)or ureteroscopic lithotripsy(URSL)from May 2015 to May 2016,and stone diameter was 0.8-2.5 cm.Results:The operations were all successful,and the time of operation was 25～73 min(mean,48 min).The perioperative bleeding was 5～40 ml,(mean,20 ml).After the surgery for six months on average were done:no complications were found,all patients without residual stones,ureteric stricture,recurrent calculus,and hydronephrosis.Conclusions:Retroperitoneoscopic ureterolithotomy is an effective and safe operation method for the treatment in patients with mid-upper segment of ureter stones.