后腹腔镜输尿管上段切开取石术32例临床分析

目的 探讨后腹腔镜输尿管上段切开取石术技术要点和临床价值.方法 回顾32例输尿管结石患者采用后腹腔镜下输尿管上段切开取石术临床资料,其中25例术前行体外冲击波碎石术,5例曾行输尿管镜取石失败,2例术前未行其他治疗.结石直径10～26 mm,平均16 mm.结果 32例患者手术全部成功,手术时间60～120 min,平均85 min.术中出血20～80 ml.术后住院时间5～8 d.随访12～24个月,无并发症发生.结论 后腹腔镜输尿管上段切开取石术安全性高、疗效确切,具有组织损伤小,术后恢复快的特点,适用于体外冲击波碎石、输尿管镜腔内碎石失败,结石大的患者.

Treatment of retroper itoneoscopic ureterolithotomy with upper urinary tract calculi

Objective To evaluate the clinical effect and the technique of retroperitoneal laparoscopic aret-erolithotomy. Methods The clinical data of 32 cases who underwent retroperitoneoscopic ureterolithotomy were re-viewed. Twenty-five patients had a salvage procedure after unsuccessful extracorpereal shock wave lithotripsy (ESWL). Five cases were treated by uretoroscope recessive lithority(URL) but failed and 2 patients didn't have any treatment. The stone size ranged from 10 mm to 26 mm (mean 16 mm). Results All the 32 cases had successful surgery which was finished from 60 to 120 min(mean 85 min) and blood loss was from 20 to 80 ml. The average time of postoperative hospitalization was 5 to 8 days. All patients fully recovered with no complication observed during 12 to 24 months' follow-up. Conclusions Retroperitoneoscopic ureterolithotomy is safe and effective, showing advan-tages of less tissue injury with a rapid postoperative rehabilitation. It can be applied in patients with large caculi and unsuccessful therapy with ESWL or URL.