后腹腔镜技术治疗输尿管上段结石临床观察

目的探讨后腹腔镜输尿管切开取石术的临床应用价值。方法回顾性分析27例后腹腔镜输尿管切开取石术的临床资料。男性15例,女性12例。结石均位于输尿管上段,大小1.2～2.5cm。11例术前行体外冲击波碎石治疗失败。结果 27例结石均一次性完整取出。手术时间100～180min,平均130min。术中出血量50～80ml,平均60ml。术后3～5d拔除后腹腔血浆引流管,术后住院时间5～9d。27例随访6～12个月,肾积水、输尿管扩张明显减轻。结论后腹腔镜技术治疗输尿管上段结石安全有效、微创美观,值得推广。

Clinical observation on the Retroperitoneoscopic Ureterolithotomy in treatment of Upper Ureteral Calculi (With 27 Cases Reports)

OBJECTIVE To investigate the clinical value of retroperitoneoscopic ureterolithotomy in treatment of upper ureteral calculi. METHODS We retrospectively analyzed clinical data of 27 patients who had received the retroperitoneoscopic ureterolithotomy. 15 cases of them were males and 12 were females. The locations of ureteral calculi of all the patients were at upper ureter, size was at the range of 1.2-2.5cm. 11 cases had used extracorporeal shock wave lithotripsy method to deal with the calculi before the operative, but all failed. RESULTS The ureteral calculi of the 27 cases were all completely removed. The operative time was at the range of 100-180 min; The average time was 130 min. Intraoperative blood loss was at the range of 50-80ml, and the average was 60 ml. 3-5 days later the retroperitoneal drainage tube was removed, and the postoperative treatment time was at the range of 5-9d. All the patients were followed up for 6-12 months, the hydronephrosis and ureter expansion were significantly reduced comparing to preoperative. CONCLUSION The retroperitoneoscopic ureterolithotomy method in treatment of the upper ureteral calculi is safe and effective, and has the aspect of minimally invasive. This method is worthy of widely application.