腹腔镜输尿管切开取石术4例报告

目的 :探讨经腹及经后腹腔腹腔镜输尿管切开取石的效果。方法 :输尿管上段结石 3例 ,双侧输尿管下段结石 1例 ,病程 2个月～ 3年 ,结石直径 1 5～ 2 2cm ,均经ESWL无效 ;用X线体表标志定位 ,输尿管上段 3例 ,用水囊扩张腹膜后间隙 ,经后腹腔操作 ,找到输尿管 ,用尖刀或钩刀切开输尿管 ,取出结石 ,在切口直接插入双J管 ,缝合切口 2～ 3针 ;输尿管下段结石 1例 ,用超声刀切开后腹膜 ,找到输尿管 ,同样处理结石及输尿管。结果 :4例手术均成功 ,手术时间 90～ 190min ,平均 135min ,随诊 2～ 10月 ,无并发症。结论 :腹腔镜经腹及经后腹腔输尿管切开取石术创伤小、恢复快 ,值得推广。

Laparoscopic ureterolithotomy of 4 cases report

Objective:To explore the effect of transabdominal and retroperitoneal laparoscopic ureterolithotomy.Methods:There were upper ureteral calculus in 3 cases,bilateral lower ureteral calculus in 1 case,which were lasted for 1 month to 3 years, and with the diameter of calculus of 1 5 to 2 2cm.ESWL was ineffective for all.Body's surface landmark was located by X rays. Upper ureteral calculus in 3 cases were used water balloon to dilate the retroperitoneal space,operated in the retroperitoneal space,found the ureter,used the sharp scalpel or hooked scalpel to incise the ureter,takeout the calculus,inserted the double J tube in the location of the incision,sewed up the incision with 2～3 needles;Lower ureteral calculus in 1 case was used the hormonic scalpel to incise the retroperitoneum,found the ureter, processed treated the calculus and the ureter same with before.Results:4 cases were operated successfully with the operation time of 90～190mins,and were followed up for 2～10 months. No complications occurred.Conclusions:The transabdominal and retroperitoneal laparoscopic ureterolithotomy have advantages of little injury and quick recovery.