术前置D-J管后腹腔镜手术治疗输尿管结石

目的:探讨术前膀胱镜下留置D-J管后腹腔镜下输尿管切开取石治疗输尿管结石的效果。方法:对38例输尿管中上段结石患者,行后腹腔镜输尿管切开取石治疗,术前膀胱镜下留置D-J管。结果:38例手术均成功,手术完成率100%,手术时间平均50min,术中出血量平均15ml;术后漏尿3例。术后3~5d拔除后腹膜腔引流管,留置导尿5~7d,术后住院平均6d。随访2~22个月,患者肾输尿管积水明显好转,无结石复发和输尿管切口处狭窄。结论:后腹腔镜输尿管切开取石术前置D-J管安全可行;比术中置管具有损伤小、寻找输尿管容易、出血少、手术时间短、术后并发症少等优点,二者结合,适用于输尿管中上段结石的治疗。

Retroperitoneal Laparoscopic ureterolithotomy combined with preoperative ureter stent insertion for the treatment of ureteral calculi (Report of 38 cases)

Objective:To evaluate the indications, surgical techniques and clinical effects of retroperitoneoscopic ureterolithotomy combined with preoperative ureter stent insertion for the treatment of ureteral calculi.Methods:Thirty-eight cases of ureteral calculi were inclused in this study. Among them, 28 cases had upper ureteral calculi and 10, middle ureteral calculi. Results:Thirty-six cases were successfully inserted the ureter stent before operation.The mean operative time was 50.0 min, the mean blood loss was 15 ml, the mean duration of urinary leak was 4.7 d, and the mean postoperative hospital stay was 6d. No complication was found during the follow-up of 2-22 months.Conclusions:Retroperitoneal Laparoscopic ureterolithotomy combined with preoperative ureter stent insertion for the treatment of ureteral calculi is safe, effective and minimally invasive.