输尿管软镜钬激光碎石及后腹腔镜切开取石治疗直径＞1.5cm输尿管上段结石的疗效比较

目的 对比分析输尿管软镜(F-URS)与后腹腔镜(RUL)两种微创手术方式处理直径＞ 1.5cm的输尿管上段结石的临床疗效.方法 回顾性分析2010年1月至2015年3月就诊于本院的输尿管上段结石患者140例,所有患者的结石直径均＞ 1.5cm;其中行输尿管软镜钬激光碎石60例,后腹腔镜输尿管切开取石术80例,对比分析两种手术方式的手术成功率及临床并发症.结果 在结石清石率上两种手术方式无显著差别;手术时间、平均住院时间及出血情况,输尿管软镜明显优于后腹腔镜输尿管切开取石术(P＜0.05).两组手术方式术后均没有发生严重并发症.结论 对于输尿管上段结石,输尿管软镜及后腹腔镜取石术均是高效的手术选择.但输尿管软镜碎石术能明显缩短手术时间及住院时间,尤其对于肥胖结石患者的治疗具有更好的安全疗效性.

Comparison of flexible ureterorenoscopy and retroperitoneal laparoscopic ureterolithotomy in management of proximal ureteric stones greater than 15mm

Objectives To examine the outcomes and compare the the stone clearence and complications rates of Flexible Ureterorenoscopy(F-URS) and Retroperitoneal Laparoscopic Ureterolithotomy (RUL) in patients with proximal ureteral stones larger than 15mm in diameter.Methods The data of 140 patients with proximal ureteral stones who underwent F-URS and RUL between January 2010 and March 2015 were retrospectively analyzed.Of them,60 patients underwent F-URS while 80 patients were performed by RUL.Each group was compared in terms of the success rate,operation time,stone-free status,symptom-free status,blood loss,mean postoperative hospital stays and postoperative complications.Results There was no statistical difference between the groups for success rate,stone-free status and symptom-free status (P ＜ 0.05).Conclusions F-URS and RUL are both effective and reliable in the treatment of proximal ureteral stones.However,when considering the short operational and hospitalization times and the management of situations that require secondary interventions,we suggest that F-URS,as a minimally invasive method,may be the first choice in the treatment of proximal ureteral stones.