摘要
目的探讨后腹腔镜输尿管切开取石术治疗复杂性输尿管中上段结石的临床效果。方法回顾性分析我院43例复杂性输尿管中上段结石患者采用后腹腔镜输尿管切开取石术治疗的临床资料。其中男29例,女14例;年龄18～68岁,平均43岁,病程3个月～10年;结石位于上段单发39例,多发2例,中段单发2例,结石直径15.0mm～30.0mm。结石侧均有不同程度的肾积水。结果43例手术均取得成功。手术时间30～200min,平均90min。平均出血量30ml。无出血和尿漏等并发症,术后平均住院日5.5d(3～9d)。术后复查KUB无结石残留。平均随访3.6年,患肾积水较术前明显减轻,IVU提示患肾功能改善,无输尿管狭窄和结石复发。结论后腹腔镜输尿管切开取石术治疗复杂性输尿管中上段结石效果确切,损伤小,并发症少,对腹腔镜技术熟练的术者可作为首选的治疗方法。
Objective To evaluate the clinical effect of retroperitoneal laparoscopic ureterolithotripsy in the treatment of complicated upper-mid ureteral stones. Methods Retroperitoneal laporascopic ureterolithotripsy was performed in 43 serial cases , including 29 men and 14 women with the age ranged from 18 to 68 years old （averge age： 43 years old）, the course of the disesse ranged from 3 months to 10 years. 39 cases suffered from solitary and 2 cases suffered from multiple stones in upper ureter, the other 2 cases had solitary stone in mid-ureter. The mean stone area was 22.0 mm×14.0 mm. The kidneys located in the same side with the stones had suffered from varying degree of hydronephrosis. Results All operations were successful with no complication such as bleeding and urine leakage. The average operation time was 90 minutes （30-200 minutes）, the average blood loss was 30 ml, and the mean hospital stay was 5.5 days （3-9 days） afer operation. Post-operation KUB showed that all stones were removed. It indicated that the hydronephrosis of the kidney had obviously released and the renal function became better in the 3.6 years follow-up, with no recurrece of ureteral stricture and stones. Conclusions Retroperitoneal laporascopic ureterolithotripsy in treatment with upper-mid ureteral stones is indeed effecteive with smaller injury and fewer complication. It can be the first choice for the operators with perfect skill.
出处
《中华腔镜泌尿外科杂志（电子版）》
2008年第4期19-21,共3页
Chinese Journal of Endourology(Electronic Edition)
