后腹腔镜输尿管切开取石术治疗输尿管上段嵌顿性结石

Retroperitoneal Laproscopic Ureterolithotomy for the Impacted Upper Ureter Calculi

后腹腔镜,输尿管切开取石术,输尿管结石目的:评价后腹腔镜输尿管切开取石术(RLUL)治疗输尿管上段嵌顿性结石的安全性和有效性。方法:回顾分析2013年1月~2016年12月采用RLUL术治疗的40例输尿管上段嵌顿性结石,对手术方法、治疗效果及并发症进行系统分析。结果:所有病例均顺利取出结石:手术时间(76.5 ±21.3) min、术中失血量(35.6 ±9.8) ml、术后肠道恢复时间(19.2 ±7.4) h、术后住院时间(8.6 ±1.3) d,无漏尿、感染、输尿管狭窄等并发症发生。结论:RLUL术治疗嵌顿性输尿管嵌顿性上段结石疗效确切、安全性高,术中对结石的定位及输尿管切口的缝合是手术的关键。

Objective:To assess the safety and efficacy of retroperitoneal laparoscopic ureterolithotomy(RLUL).Methods:From January of 2013 to December of 2016,40 patients with calculus in the impacted upper ureter were treated with RLUL;the surgical methods,treatment effects and complications were systematically analyzed.Results:All the operations were successful with complete stone clearance.The operative time,intraoperative blood loss,mean postoperative intestinal function recovery time and mean postoperative hospital stay was(76.5±21.3)min,(35.6±9.8)ml,(19.2±7.4)h,(8.6±1.3)d respectively.Follow-up was ranged from 3 to 18 months;no major postoperative complication occurred.Conclusions:RLUL for impacted upper ureteral calculi is feasible,safe and effective,and precise positioning of the stones and ureteral wall suture technique is the key to the success of the surgery.