后腹腔镜在输尿管手术中应用

目的:探讨经后腹腔镜行输尿管手术的临床疗效。方法:对20例输尿管疾病患者采用经后腹腔镜输尿管手术,其中行输尿管上段切开取结石术16例,行肾盂输尿管成形术4例。结果:20例手术均获成功,术中出血量20～80ml,平均43ml;术后肛门恢复排气18～36h,平均25h;吻合口或切口无漏尿,术后住院时间4～11d,平均7d。所有患者随访2～6个月,静脉肾盂造影(IVU)或B超均提示肾积水明显改善,无输尿管狭窄。结论:经后腹腔镜输尿管手术具有创伤小、出血少、胃肠道干扰小、术后恢复快、住院时间短等特点,具有良好的临床应用前景。

Application of retroperitoneal laparoscope in ureteral operation: Report of 20 cases

Objective:To evaluate the clinical efficacy of ureteral operation with retroperitoneal laparoscope. Methods:20 patients with ureteral disease were treated with retroperitoneal laparoscope. In these cases,16 cases underwent ureterolithotomy;4 cases pyeloureteroplasty.Results:All the operations were successful. The intraoperative blood loss was 20~80 ml(mean 43 ml). Passage of gas by anus need 18~36 hours(mean 25h).And the postoperative hospitalization was 4~11 days(mean 7 days).No complications were found during operation and the follow up period was 2~6 months in 20 cases.Conclusion:The ureteral operation with retroperitoneal laparoscope has the advantages of minimal invasion,less blood loss,little interference with gastrointestinal tract,and rapid postoperative rehabilitation,which has a promising future in the urologic clinical practice.