后腹腔镜输尿管切开取石术手术并发症的临床分析  

Clinical analysis of complications in retroperitoneal laparoscopic ureterolithotomy

作　　者：蒋武斌[1] 陈柏康[1] 吴松江[1] 

机构地区：[1]浙江省台州医院泌尿外科,浙江台州317000

出　　处：《临床泌尿外科杂志》2012年第6期461-463,共3页Journal of Clinical Urology

摘　　要：目的:分析后腹腔镜输尿管切开取石术手术并发症的原因,探讨其预防方法,进一步提高手术的安全性。方法:2005年6月～2010年2月采用后腹腔镜输尿管切开取石术治疗输尿管上段结石患者409例,统计其并发症发生类型,分析发生原因。结果:术中及术后发生并发症39例,其中术中并发症12例:因结石移位及局部粘连中转开放7例,血管损伤4例,输尿管横断1例;术后并发症27例:尿漏10例,切口感染2例,结石残留2例,皮下气肿10例,输尿管狭窄3例,其中需要再次手术者7例。结论:后腹腔镜输尿管切开取石术手术并发症的发生主要与手术适应证的选择、手术操作、术中输尿管的切开方式及输尿管支架管的正确放置有关;选择合适的病例、仔细正确的手术操作才能减少手术并发症的发生。Objective： To evaluate the causes and prevention of complications in retroperitoneal laparoscopic ureterolithotomy. Methods：From August 2003 to July 2010, 409 patients with upper ureteral stones underwent retroperitoneal laparoscopic ureterolithotomy. The intra and post-operative complications were retrospectively re- viewed and clinically analyzed. Results： Overall, 39 cases had complications, Intraoperative complications occurred in 12 cases, including 7 cases of stone migrations and sever adhesion, which converted to open surgery; 4 of vas- cular injuries; 1 of ureteral injury. Postoperative complications occurred in 27 cases, including 10 of urinary leak- age; 2 of incision infectiom2 of stone residue; 10 of subcutaneous emphysema~ 3 of stricture ureter. 7 cases o{ postoperative complications were resolved by operations. Conclusions： The proper selection and surgical technique can reduce the risk of complication in retroperitoneal laparoscopic ureterolithotomy.

关 键 词：输尿管上段结石 腹腔镜术 并发症 

分 类 号：R693[医药卫生—泌尿科学]