后腹腔镜与经腰背部直切口途径行输尿管切开取石术的疗效比较  

Comparison of the effect between retroperitoneal laparoscopic and lumbar straight incision ureterolithotomy

作　　者：覃树芳 

机构地区：[1]广东省东莞市石碣人民医院外科,523290

出　　处：《中国现代医药杂志》2006年第3期17-19,共3页Modern Medicine Journal of China

摘　　要：目的比较后腹腔镜与经腰背部直切口途径行输尿管切开取石术治疗输尿管上段结石的疗效,探讨两种术式的关键步骤。方法输尿管上段结石患者43例,病程6个月～3年,结石直径1.5～3.0cm。26例经体外冲击波碎石(ESWL)无效,4例经输尿管镜取石失败。其中15例行后腹腔镜输尿管切开取石术,28例行经腰背部直切口输尿管切开取石术。两组术中均留置双J管。结果43例手术全部成功,后腹腔镜组和经腰背部直切口组的手术时间分别为(85±13)vs(73±9)min(P<0.05),出血量为(45±6)vs(60±10)ml,止痛剂(曲马多)(80±8)vs(150±5)mg(P<0.05),术后住院时间(6±0.5)vs(10±0.4)天(P<0.05)。随访6～12个月,两组无并发症发生。结论与腰背部直切口途径比较,后腹腔镜输尿管切开取石术虽手术时间稍长,但手术创伤小、术后恢复快,对于已有一定腹腔镜经验的医院,可为首选术式。Objective To compare the surgical outcome and investigate the major techniques between retroperitoneal laparoscopic and lumbar straight incision ureterolithotomy. Methods 43 patients who had upper urinary tract calculi with the course from 6 months to 3 years were enrolled in this study. The size of the calculi was 1.5 to 3.0 cm in diameter. ESWL was ineffective in 26 of the patients and ureteroscopic lithotomy failed in 4 of them. Of 43 cases,15 patients underwent retroperitoneal laparoscopic ureterolithotomy and 28 underwent lumbar straight incision ureterolithotomy. Double J stents were used in all cases. Results All the operations were successful. In the laparoscopic group and open group, the operations was respectively （85±13） vs （73±9） min （P〈0.05）;the blood loss was （45±6） vs （60±10）ml;the dosage of analgesic（Tramal） was （80±8） vs （150±5） mg（P〈0.05） and hospital stay was （6±0.5） vs （10±0.4） days （P〈0.05）. No postoperation complications occurred in all cases during 6 months to 12 months follow-up. Conclusions Comparing with the open surgery, retroperitoneal laparoscopy surgery is a time consuming operation ,but is a minimal invasive one and bear rapid postoperative rehabilitation.For hospitals with certain laparoscopy experience ,it may be the first line treatment for upper urinary tract calculi.

关 键 词：输尿管结石 腹腔镜 开放手术 输尿管切开 

分 类 号：R699[医药卫生—泌尿科学]