肾盂、输尿管上段复杂结石的后腹腔镜手术治疗体会

目的]肾盂、输尿管上段复杂结石的多种治疗方法中,后腹腔镜手术治疗成为优先考虑。总结后腹腔镜手术治疗肾盂、输尿管上段结石的操作技巧和临床经验。方法]采用后腹腔镜对19例肾盂、输尿管上段结石进行切开取石术,结石长径13～45mm,平均20mm。宽径10～15mm,平均13mm。病程6个月～10年,平均3年。结果]本组19例均获成功,其中6例输尿管上段结石合并中度肾积水,10例为肾盂结石合并有轻度肾积水,有3例为鹿角型结石。在后腹腔镜下进行了肾盂输尿管切开取石术。手术时间55～130min,平均90min。术中出血50～80ml,平均70ml。术后随诊时间1～3个月,无并发症。结论]肾盂、输尿管上段复杂结石用后腹腔镜治疗是安全可靠的首选微创技术。

RETROPERITONEAL LAPAROSCOPY FOR PYELIC AND UPPER URETERAL COMPLICATED CALCULI

Objective]In a variety of treatment methods for pyelic and upper ureteral complicated calculi,retroperitoneal laparoscopic treatment should be given priority.The skills and clinical experiences of retroperitoneal laparoscopy would be summarized.Methods]Retroperitoneal laparoscopy was used to treat 19 patients with pyelic and upper ureteral calculi.Themean length of calculi was 20mm(13-45mm),and mean width of calculi was 13mm(10-15mm).These patients had mean clinical course of 3 years(6 months-10 years).Results]All stones were successfully removed with median operation time of 90min(55-130min),and median blood loss of 70ml(50-80ml).Among all these 19 cases,6 cases had moderate hydronephrosis,10 cases had mild hydronephrosis,and 3 cases had staghorn calculi.Patients were followed up 1 to 3 months,no complications.Conclusion]Retroperitoneal laparoscopy was safe and reliable minimally invasive treament for pyelic and upper ureteral complicated calculi.