后腹腔镜下输尿管切开取石术治疗输尿管上段结石

目的探讨后腹腔镜下输尿管切开取石术的适应证、技术要点及临床价值。方法采用后腹腔镜下输尿管切开取石术治疗输尿管上段结石24例，结石直径15～28mm；其中20例曾经1～2次体外冲击波碎石无效。4例经输尿管镜取石失败。全部病例均采用经后腹腔途径切开取石。结果本组22例手术取得成功。2例改开放手术。手术时间35～120min，平均65min，术后恢复顺利，随访2～32个月，23例患者肾输尿管积水均明显好转，肾功能改善。1例患者术后半年又出现重度肾积水，行输尿管狭窄段切除吻合术后治愈。结论后腹腔镜下输尿管切开取石术，可以完整取出结石，具有微创的优势，是治疗输尿管上段结石较理想的方法。

Laparoscopic ureterolithotomy for the treatment of upper ureter calculi

Objective To explore the technique and clinical value of laparoscopic ureterolithotomy for the treatment of upper ureter calculi.Methods 24 cases of upper ureter calculi were treated with retroperitoneoscopic ureterolithotomy(the stone size ranged from 15-28mm),among whom 20 patients were treated with unsuccessful ectracorporeal shockwave lithotripsy (ESWL) and 4 patients with ureteroscopy(URS).Results In this study 22 cases were successfully treated but 2 cases converted to open surgery.The operation time ranged from 35 to 120 minutes(mean 65 minutes).During 2-32 months follow up,the renal function of 23 patients was improved but only 1 patient had the recurrence hydronephrosis,who was treated with anastomosis of stricture of the ureter.Conclusion Retroperitoneoscopic ureterolithotomy is a safe and effective minimally invasive procedure,which can remove the stone completely.