后腹腔镜肾盂输尿管切开取石术45例报告

目的 探讨后腹腔镜肾盂输尿管切开取石术的技术要点及临床价值。方法 采用后腹腔镜完成45例肾盂输尿管切开取石术，病程10个月～6a，结石直径1．1～3．2cm；12例经ESWL无效，2例经输尿管镜取石失败；输尿管上段结石37例，肾盂结石8例。结果 结石均一次取净，手术55～130min，平均75min，无明显并发症发生。术后恢复顺利，随访3～12个月，患者肾输尿管积水均明显好转，无结石复发和切开缝合处狭窄。结论 后腹腔镜肾盂输尿管切开取石术具有损伤小、安全有效、可行和恢复快等优点，有良好的临床应用价值。

Retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy (Report of 45 cases)

Objective] To evaluate the surgical technique and clinical application of retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy. Meahods] 45 cases of pelvis or ureteral stone have been treated by retroperitoneal laparoscopy suegery. The size of the calculi was 1.1~3.2 cm; the course was from 10 months to 6 years. ESWL has been failed in 12 of them, ureteroscopy been failed in 2 of them. Of the 45 cases, 37 had upper ureteral stones and 8 had pelvis stones. Results] All the stones were completely removed by single procedure. The operation time was 55~130 min with a mean of 75 min. No obvious complication has been observed. During the follow up period (3~12 months), no ureteric stricture or recurrent calculus was found. B-ultrasound and IVP examinations showed that hydronephrosis and hydroureterosis were lessened. Conclusions] Retroperitoneal laparoscopic pyelolithotomy or ureterolithotomy has advantages of being minimal invasive, safe and effective, postoperatively early resumption and shorter hospital stay. It has a good applied value in the urologic clinical practice.