后腹腔镜输尿管手术的改良应用

目的：探讨改良后腹腔镜输尿管手术的技术方法以及在治疗输尿管疾病中的应用价值和效果。方法：回顾性分析2006年3月～2008年12月间应用改良后腹腔镜输尿管手术治疗的47例输尿管结石、腔静脉后输尿管、UPJ连接处梗阻、输尿管狭窄患者的临床资料。结果：47例手术均取得成功，平均手术时间96min，术中出血20ml，无手术相关并发症，无中转开放手术者。其中38例患者平均随访15个月，复查B超或IVU提示患侧输尿管通畅，同侧肾积水明显减轻，无吻合口狭窄、尿瘘、感染等并发症。结论：改良后腹腔镜输尿管手术简单易行，显著减少手术时间，效果确切，值得临床推广。

Modified Application of Retroperitoneal Laparoscopic Techniques for Ureteral Diseases

Objective： To investigate the techniques of modified retroperitoneal laparoscopic ureteral surgery and evaluate the value and effect in the treatment of ureteral obstruction. Methods：Clinical data of 47 cases with ureteral stone, retrocaval ureter, ureteropelvic junction obstruction and ureterostenosis from March 2006 to December 2008 were retrospectively analyzed. All diseases were treated by modified retroperitoneal laparoscopic ureteral surgery. Results： All the operations were completed successfully and no case was converted to open. The mean operating time was 96 minutes, the mean blood loss was 20 ml, and there were no operative complications. 38 cases have been followed up for average 15 months. Ultrasound 13 investigation and IVU analysis showed the ill side ureteral unobstructed and hydronephrosis decreased after the procedure. There were no anastomotic stricture, urinary fistula, infection or other further complication. Conclusions： The modified retroperitoneal laparoscopic ureteral surgery is simple and easy to perform, which can reduce the operation time significantly and also be effective in treatment of ureteral obstruction.