输尿管镜与后腹腔镜手术治疗输尿管上段结石疗效比较

目的评估两种微创手术治疗输尿管上段结石的疗效。方法34例输尿管上段结石患者,其中19例行输尿管镜碎石取石术,15例行后腹腔镜输尿管切开取石术,术中均留置双J管。结果手术均获成功,术中无一例转为开放手术,术中无明显并发症发生;输尿管镜组16例一次成功取尽结石,3例经二期手术后成功排出,平均手术时间70min;后腹腔镜组15例均一次成功取尽结石,平均手术时间85min,术后无漏尿发生。结论后腹腔镜输尿管切开取石术较输尿管镜碎石取石术一次手术成功率高,对于有一定腹腔镜使用经验者是一种安全有效的方法。

The Comparison Between Ureteroscopic Lithotripsy and Retroperitoneal Laparoscopic Ureterolithotomy for treatment of Upper Ureteral Calculus

Objective To evaluate the effect of ureteroscopic lithotripsy and retroperitoneal laparoscopic ureterolithotomy for the treatment of upper ureteral calculus. Methods 34 patients with upper ureteral calculi were enrolled in the study.19 cases were treated with ureteroscopic lithotripsy and 15 cases retroperitoneal laparoscopic ureterolithotomy. Double J stents were used in all cases. Results All the operations were successful. None of 34 cases transfered to open operation. No severe complications happened during operation. 16 cases were successful in removing the calculi in the first operation using ureteroscope lithotripsy.The mean operative time was 70 minutes.All 15 cases who underwent retroperitoneal laparoscopic ureterolithotomy were removed calculus in the first surgery. The mean operative time was 85 minutes.No leakage of urine was observed after surgery. Conclusion The retroperitoneal laparoscopic ureterolithotomy have a high success rate and is a safe and effective way for the treatment of upper ureteral calculus.