后腹腔镜在输尿管切开取石术中的应用

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9月，对66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，以4-0人工合成可吸收线（SAS）间段缝合输尿管切口。结果66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，无一例发生尿漏。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1-33个月，平均16.3个月，超声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他手术，值得推广应用。

The application of retroperitoneoscopic ureterolithotomy in treatment of impacted stone of upper ureter

Objective To summarize our experience and evaluate the outcome of retroperitoneal laparoscopic ureterolithotomy of the upper ureter impacted stone. Methods Between Dec 2006 and Sep 2009, 66 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. 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 1-33 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.