后腹腔镜下肾、肾盂输尿管切开取石术(附65例报告)  

Retroperitoneal laparoscopic renal-pyelo-uretero-lithotomy for 65 cases

作　　者：蒋振华[1] 杨林斌[1] 顾燕琴[1] 俞增福[1] 何屹[1] 侯岩松[1] 王华[1] 

机构地区：[1]嘉兴学院医学院附属第一医院泌尿外科,浙江嘉兴314000

出　　处：《中国内镜杂志》2009年第12期1308-1310,共3页China Journal of Endoscopy

摘　　要：目的探讨后腹腔镜下肾、肾盂输尿管切开取石术的技术要点和临床价值。方法采用后腹腔镜对65例肾、肾盂、输尿管中上段结石进行切开取石术,结石直径10～27mm,平均18.5mm。病程3个月～11年,平均4.3年。结果65例患者,除2例由于输尿管结石上移改开放性手术,1例肾结石合并输尿管下段结石伴重度肾积水者,输尿管下段结石采用输尿管镜下气压弹道碎石后,再行后腹腔镜下肾实质切开,未发现结石,仅行肾折叠术。其余62例均手术成功,其中3例输尿管结石合并重度肾积水,在后腹腔镜下同时进行了输尿管切开取石术+肾折叠术。手术时间45～140min,平均70min。术中出血50～80mL,平均65mL。术后随诊时间1～6个月,无中远期并发症。结论后腹腔镜下肾、肾盂输尿管切开取石术是有效的微创技术。[ Objective] To evaluate the clinical roles of retroperitoneal laparoscopic renal-pyelo-ureterolithotomy in the treatment of kidney, pelvic and uretal stones. [Methods] Retroperitoneosoopic ureterolithotomy was performed on 65 cases diagnosed as kidney, pelvic and uretal stones. The size of the calculi was 10-27 mm （mean 18.5 mm） with the disease course of 3 month-11 years （mean 4.3 years）. [Results] The operation was successfully completed in 62 cases and a conversion to open surgery was required in 2 case because of upward moving of the stones. The operating time was 45-140 min （mean 70 min）; the intraoperative blood loss was 50-80 mL （mean 65 mL）. No complication was observed during a 1-6 month follow-up. [ Conclusions] Retroperitoneal laparoscopie renal-pyelo-uretero-lithotomy is an efficient minimally-invasive surgical technique.

关 键 词：腹腔镜 肾 肾盂 输尿管 结石 

分 类 号：R693.4[医药卫生—泌尿科学]