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经腹腔入路腹腔镜切开取石术治疗第三腰椎以下嵌顿性输尿管上段结石 被引量:2

Laparoscopic ureterolithotomy in treatment of impacted upper ureteral calculi below the third lumbar vertebra via transperitoneal approach
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摘要 目的:探讨经腹腔入路腹腔镜输尿管切开取石术治疗嵌顿性输尿管上段结石的方法与临床价值.方法:2013年1月~2014年2月,经腹腔入路腹腔镜切开取石术治疗第三腰椎(L3)以下嵌顿性输尿管上段结石18例,其中7例术前行体外冲击波碎石失败.结石长径1.3~3.0 c m,平均2.1 c m.结果:手术均获成功,无中转手术病例.手术时间45~130 mi n ,平均75 mi n .术中估计失血量20~55 ml ,平均35 ml .术后1例出现漏尿,引流2周后消失.无肠梗阻等并发症.术后随访1~11个月,平均5个月,无结石复发和输尿管狭窄病例.结论:对于 L3以下嵌顿性输尿管上段结石,经腹腔入路腹腔镜输尿管切开取石术具有空间大、解剖标志清晰、避免反角度操作等优势,值得临床选用. To explore the method and clinical value of laparoscopic ureterolithoto my intreatment of impacted upper ureteral calculi below the third lumbar vertebravia transperitoneal approach .Methods :From January 2013 to February 2014 ,laparoscopic ureterolithoto my was carried out on 18 patients with impacted upper ureteral calculivia transperitoneal access .Of all patients ,7 had been treated with ES WL before .The mean stone size was 2.1cm (range 1.3 to 3.0 cm).Results :Laparoscopic ureterolithoto my was successfully performed on all cases without conversi on to open surgery .Mean operative time was 75 min (range 45 to 130 min ).Mean esti mated blood loss was 35mL (range 20 to 55mL ).Urine leakage occurred in one case and disappeared by drainage for 2 weeks .Mean fol-low- up period was 5 months (range 1 to 11 months ),and no ureteric stricture or recurrent calcul us were found .Con-clusions :Laparoscopic ureterolithoto my via transperitoneal approach deserves clinical applicati on in treat ment of im-pacted upper ureteral calculi for the advantages of spacious space ,clear anato mical land marks and relati vely simple manipulation .
出处 《微创泌尿外科杂志》 2014年第2期103-104,共2页 Journal of Minimally Invasive Urology
基金 国家自然科学基金(81360126)
关键词 腹腔镜 输尿管切开取石 上段输尿管结石 嵌顿 经腹腔 laparoscopy ureterolithotomy upper ureteral calculi impacted transperitoneal approach
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