后腹腔镜与开放手术治疗输尿管上段结石的疗效研究

目的通过后腹腔镜输尿管上段切开取石术手术结果相关指标与开放手术对比,探讨后腹腔镜治疗输尿管结石的利弊及手术适应证,指导临床工作。方法回顾性分析22例后腹腔镜输尿管切开取石术(腹腔镜组)和20例开放性输尿管切开石术(对照组)患者的临床资料,手术并发症、肠功能恢复时间、拔除引流管时间、拔除导尿管时间、术后住院时间、术中出血量。结果所有病例术中及术后近期均未发生严重并发症。术中出血量、术后肠功能恢复时间腔镜组少于对照组(P<0.05);术后拔除引流管时间和拔除导尿管时间2组比较无显著差异(P>0.05);术后住院时间腔镜组少于对照组(P<0.05)。结论后腹腔镜输尿管切开取石术适应证与开放手术相当,可以部分取代开放手术方式,具有一定推广价值。

Study on retroperitoneal laparoscopic ureterolithotomy versus open surgery for treatment of ureteral calculi

Objective To guide the clinical practice,the paper is to investigate the advantage,disadvantage and indication of the treatment of improved retroperitoneal laparoscopic ureterolithotomy compared with open ureterolithotomy.Methods Twenty two cases treated with retroperitoneal laparoscopic ureterolithotomy and 20 cases with open ureterolithotomy were reviewed retrospectively.Patient's clinical data,surgical complications,time of intestinal function recovery,postoperative removal of drainage tube,removal of the catheter,postoperative hospital stay,and intraoperative blood loss were retrospectively analysed.Results No serious complications occurred in all cases during intraoperation and postoperation.Compared with open ureterolithotomy group,the time of intestinal function recovery and the hospital stay were shorter(P<0.05),and intraoperative blood loss was less(P<0.05);the time of drainage-tube and urinary catheter extracted showed no significant difference(P>0.05).Conclusion With technological improvement,the retroperitoneal laparoscopic ureterolithotomy showed certain advantage like safe and effective mini-invading operation.Compared with open ureterolithotomy,its indication was equal,and it may replace parts of open operation and has certain popularized value.