后腹腔镜输尿管切开取石术28例报告

目的探讨后腹腔镜输尿管切开取石术的疗效。方法2009年8月至2011年12月采用后腹腔镜行输尿管切开取石术对输尿管中上段结石患者28例进行治疗，所有病例术前均经B超、静脉肾孟造影或cT确诊为输尿管中段或上段阳性结石，结石直径15～30mm。结果手术时间50～150rain，平均80rain；出血量20～50ml，平均35ml；2例因结石返回肾盂改经皮肾镜手术，2例术后出现漏尿，延迟拔除引流管，术后14d漏尿结束，拔除引流管。无其他并发症。结论后腹腔镜下输尿管切开取石术安全有效，可作为一种治疗输尿管中上段结石的重要方法。

Study on clinical effect of retroperitoneoscopic ureterolithotomy:areport of 28 cases

Objective To assess the clinical effect of retroperitoneoscopic ureterolithotomy. Methods Twenty eight cases of upper or middle nreteral calculi were treated by retroperitoneoscopic ureterolithotomy during August 2009 to December 2011. Before operation, all cases were diagnosed as upper or middle ureteral calculi by B - ultrasound scanning, IVP and CT scanning. The size of stones ranged from 15 mm to 30 mm. Results The operating time was 50 ~ 150 minutes （ with an average of 80 minutes） , the amount of blood loss was 20 ~ 50 ml （ with an aver- age of 35ml）. Stone returned to renal pelvis in 2 cases, and they were treated by percutaneous nephrolihotomy. Postoperative urethral fistula had been happened in 2 cases, and it stopped at 14 days later by prolonging the duration of drainage tube. There was no other complications. Conclu- sion Retroperitoneascopic ureterolithotomy is safe and effective, it may be applied as an important treatment approach for upper or middle ureteral calculi.