后腹腔镜肾盂上段输尿管切开取石术的临床分析  

A clinical analysis of retroperitoneoscopic pelviotomy and ureterolithotomy

作　　者：麻立[1] 倪少滨[1] 王春阳[1] 段永顺[1] 焦治兴[1] 

机构地区：[1]哈尔滨医科大学附属第一医院泌尿外科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2013年第1期94-96,共3页Journal of Harbin Medical University

摘　　要：目的探讨后腹腔镜肾盂或输尿管切开取石治疗肾或输尿管上段结石的适应证,手术技巧和临床价值。方法回顾分析采用后腹腔镜治疗肾盂结石1例,输尿管结石4例,输尿管结石位于L3～L5平面,5例患者术前行ESWL治疗失败,结石直径1.5～2.0 cm,平均1.8 cm。结果 5例患者均手术成功,手术时间110～175 min,平均145 min:术中出血量30～50 mL,平均35 mL;术后无漏尿;患者术后3～5 d拔出腹膜后引流管,术后住院5～7 d,平均5.8 d。结论后腹腔镜肾盂输尿管切开取石术可作为体外冲击波碎石治疗失败的补救措施,对于不适合经皮肾镜或输尿管镜治疗的结石可作为首选治疗方法,具有取石取净率高,损伤小,安全,可靠等优点。Objective To evaluate the indications, surgical techniques and clinical value of retroperitoneoscopic pelviotomy and ureterolithotomy in the treatment of upper urinary calculi. Methods Retroperitoneoscopie pelviotomy was performed in 1 patient with renal pelvis stone, and retroperitoneoscopic ureterolithotomy was utilized in 4 patients with ureteral stones, respec- tively. The stone located in the L3 - L5 plane and stone diameter varied from 1.5 to 2. 0 cm （ mean 1.8 cm）. All patients were failed in the treatment of ESWL. The clinical data on perio- perative parameters were analyzed retrospectively. Results The procedure was successfully accomplished in all cases. The operative time ranged from 110- 175 min （mean 145 min） The blood loss ranged from 30-50 mL （mean 35mL） and retroperitoneal drainage tube was re- moved in 3 to 5 d after operation. The hospital stay was 5- 7 d （mean 5.8 d）. No leakage of urine was found in all patients. Conclusion Retroperitoneoscopie pelviotomy and ureterolitho- tomy is a safe, effective and minimally invasive procedure with the advantages of high stone re- moval rate, which provides a reliable alternative to ESWL, PCNL or URL in the selected pa- tients.

关 键 词：后腹腔镜 肾 输尿管上段结石 肾盂输尿管切开取石 

分 类 号：R692.4[医药卫生—泌尿科学] R693.4[医药卫生—外科学]