体外冲击波碎石术失败后输尿管结石的腹腔镜手术  

Laparoscopic ureterolithtomy for managing ureteral calculi failure to ESWL

作　　者：梅方[1] 应永强[1] 秦勇[1] 张大宏[2] 

机构地区：[1]浙江省杭州市红十字会医院泌尿外科,浙江杭州310003 [2]浙江大学医学院附属邵逸夫医院,浙江杭州310016

出　　处：《中国内镜杂志》2006年第7期753-755,共3页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜下输尿管切开取石术处理体外冲击波碎石术(ESWL)失败后输尿管结石的临床意义和初步经验。方法从2003年6月～2005年6月作者对ESWL治疗失败后的25例输尿管结石患者行经腹腔途径腹腔镜下输尿管切开取石术。其中男12例,女13例,平均48.1岁;输尿管上段结石15例,中段结石10例;左侧10例,右侧15例;结石大小平均为1.3cm×1.5cm,均伴有不同程度肾积水。结果手术均取得成功,手术45～110min,平均70min,失血20～60mL,术后住院3～5d,无尿漏,随访6￣16个月,输尿管无狭窄,肾积水改善。结论腹腔镜输尿管切开取石术是治疗ESWL失败后的输尿管结石有效、适宜的微创技术,创伤轻,痛苦少,恢复快,可替代开放输尿管切开取石术。[Objective] To introduce the technique of laparoscopic ureterolithotomy after failure of ESWL and to analyse the technique＇s significances and primary experiences. [Methods] 25 cases of ureteral calculi after failure of ESWL were treated by laparoscopic ureterolithotomy from 2003. 6 to 2005. 6. There were 12 male patients and 13 female with an average age of 48.1 being 15 upper ureteral stone, 10 middle ureteral stone. Of them 10 cases had calculi on the left side and 15 cases on the right side. [Results] All operations were successful and mean time of operation was 70 min. Blood lost volume was 20 -60 mL, and postoperative hospital stay time was 3-5 d without urinary leakage. During the follow up of 6-16 months no ureteral stricture was found. The hydronephrosis were improved. [Conclusion] Laparoscopic ureterolithtomy is the microinvasive technique and the alternative surgery to treat ureterolithiasis which was failed after ESWL. It is a safe, less traumatic and effective method.

关 键 词：腹腔镜输尿管结石手术 体外冲击波碎石术 输尿管结石 

分 类 号：R693.4[医药卫生—泌尿科学]