腹膜后腹腔镜输尿管切开取石术治疗上段输尿管嵌顿性结石35例报告

目的:探讨腹膜后腹腔镜输尿管切开取石术(retroperitoneal laparoscop ic ureterolithotomy,RPLU)治疗上段输尿管嵌顿性结石的可行性、疗效及手术技巧。方法:回顾分析2007年6月至2009年12月为35例上段输尿管嵌顿性结石患者行RPLU的临床资料。结果:35例均顺利完成RPLU,其中32例同时行腹腔镜输尿管炎性息肉电凝毁损术,3例行狭窄段输尿管切除+输尿管端端吻合术,手术时间45~127m in,平均83m in,出血量5~30m l,平均14.5m l,无术中大出血发生,术后3~6d出院,无尿漏,复查尿路平片(k idney ureter b ladder,KUB)及B超示无结石残留,4~6周拔除双"J"管。随访所有病例6~35个月,平均19个月,KUB及B超检查无结石复发及输尿管狭窄,27例中度肾积水患者3~6个月后缓解为轻度肾积水,12~18个月后积水基本消失;8例重度肾积水患者6~9个月后缓解为中度肾积水,10~35个月缓解为轻-中度肾积水。结论:RPLU是治疗上段输尿管嵌顿性结石的微创手段,具有与开放手术同样肯定的疗效,且具有患者创伤小、痛苦轻、康复快等优点,对挽救患者患侧肾功能具有非常重要的意义,值得临床应用与推广。

Retroperitoneal laparoscopic ureterolithotomy for treatment of impacted upper ureteric calculi:a report of 35 cases

Objective:To explore the feasibility,therapeutic effect and operative technique of retroperitoneal laparoscopic ureterolithotomy(RPLU) for treatment of impacted upper ureteric calculi.Methods:The clinical data of 35 patients suffered from impacted upper ureteric calculi and underwent RPLU between Jun.2007 and Dec.2009 was analyzed retrospectively.Results:RPLU was successfully performed in all cases,laparoscopic ureteral inflammatory polyp electrocoagulation ablation was performed in 32 cases,resection of ur...