后腹腔镜输尿管切开取石术在嵌顿性结石中的应用（附58例报告）

目的：探讨后腹腔镜输尿管切开取石术治疗嵌顿性输尿管结石的临床价值和技术要点。方法：2006年12月至2009年3月,对58例嵌顿性输尿管中上段结石采用后腹腔镜输尿管切开取石术,术中取石后于镜下直接置入双J管,间段缝合输尿管切口。结果：58例手术均获成功,无中转开放手术,结石清除率100%。术后创腔引流液量少,3～5d拔除引流管,1周出院,术后3周膀胱镜下拔除双J管。随访1～27个月,B超复查显示肾积水明显好转或消失,无结石复发。结论：后腹腔镜输尿管切开取石术治疗嵌顿性输尿管结石具有创伤小／疗效好、术后恢复快等特点,明显优于开放手术及其它手术,值得推广应用。

The Application of Retroperitoneoscopic Ureterolithotomy in Treatment of Impacted Stone of Upper Ureter（Reports of 58 Cases）

Objective：To summarize our experience and evaluate the outcome of retroperitoneal laparoscopic ureterolithotomy of the upper ureter impacted stone.Methods：Between December 2006 and March 2009,58 patients underwent retroperitoneal laparoscopic ureterolithotomy of the upper ureter.After removal of the stones,the double J was put in and interrupted suture was performed for upper ureter.Results：Retroperitoneoscopic ureterolithotomy was successful in all patients,there was neither ureteral stricture nor recurrent calculus,the blood loss ranged from 5-10 mL,without urine leakage occurred.The mean hospital stay was 7 days,after 3 weeks double J was removed by cystoscopy.With 1-27 months follow-up,the hydronephrosis relieved and no recurrence of ureter calculus founded. Conclusion：Retroperitoneoscopic ureterolithotomy is a safe and effective minimally invasive operation,and worth to generalization.