后腹腔镜输尿管切开取石术治疗大体积输尿管上段结石  

Retroperitoneal laparoscopic ureterolithotomy for treatment of huge upper ureteric calculi

作　　者：王军凯[1] 高轶[1] 崔心刚[1] 刘玉杉[1] 阴雷[1] 姚亚成[1] 陈杰[1] 陈露[1] 李尧[1] 徐丹枫[1] 

机构地区：[1]第二军医大学附属长征医院泌尿外科全军泌尿外科中心,上海200003

出　　处：《微创泌尿外科杂志》2014年第1期30-31,共2页Journal of Minimally Invasive Urology

摘　　要：目的：探讨后腹腔镜输尿管切开取石术治疗大体积输尿管上段结石的可行性、有效性及临床经验.方法：对7例大体积输尿管上段结石的患者行后腹腔镜输尿管切开取石术,结石长径36~60 mm,平均49 mm,患侧均伴有不同程度的肾盂积水,中度1例,重度6例.结果：7例手术均一次性取石成功,手术时间55~130 min,平均(70．0±18．5)min,术中出血20~120 ml,平均(40．0±23．5)ml,术后住院4~7 d,尿管保留7 d,双J 管1个月后拔除.随访3~36个月,1例患者发生切口感染延迟愈合,无漏尿、输尿管狭窄等并发症,无结石复发.结论：该方法安全可行、疗效确切,具备良好腹腔镜下分离、缝合技巧的术者可将其作为首选治疗方法.Objective:To study the feasibility ,therapeutic effect and clinical experiences of retroperitoneal laparoscopic ureterolithotomy for huge upper ureteral calculi .Methods:Retroperitoneal laparoscopic ureterolithotomy was carried out in 7 patients withhugeupperureteralcalculi.Thestonesizerangedfrom36to60 mm(mean49 mm).Allpatientshadvarying degrees of hydronephrosis .Results:All 7 cases were operated successfully without conversion to open surgery .The operation timerangedfrom55to130 min,mean (70.0±18.5)min,andbloodlossrangedfrom20to120 mL,mean (40.0±23.5) mL.Thecatheter wasremoved7daysaftersurgery.Thepostoperativehospitalstayrangedfrom4to7days.Incisioninfec-tion occurred in one patient ,and no leakage of urine occurred .During the follow-up period ,no ureteric stricture or recurrent calculus of urine occurred.Conclusions:Retroperitoneal laparoscopic ureterolithotomyfor huge upper ureteral calculi is feasi-ble ,safe and effective ,and can be used as the first choice .

关 键 词：腹腔镜 输尿管切开取石术 大体积输尿管结石 

分 类 号：R693.4[医药卫生—泌尿科学]