腹膜后腹腔镜输尿管切开取石术治疗嵌顿性输尿管上段结石的手术技巧  

The surgical techniques of retroperitoneal laparoscopic ureterolithotomy for incarcerated upper ureteral calculi

作　　者：芮桦 徐丹枫[2] 

机构地区：[1]宜兴市人民医院,江苏宜兴214200 [2]第二军医大学附属长征医院

出　　处：《腹腔镜外科杂志》2013年第3期216-218,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹膜后腹腔镜输尿管切开取石术治疗嵌顿性输尿管上段结石的临床经验、手术技巧与疗效。方法:回顾分析2007年4月至2012年6月为55例嵌顿性输尿管上段结石患者行腹膜后腹腔镜输尿管切开取石术的临床资料,其中男30例,女25例,平均(41.3±17.5)岁。结果:55例手术均获成功,无一例中转开放;手术时间平均(57.5±22.7)min,术中出血量平均(37.5±9.1)ml,术后10 d拔除导尿管,术后平均住院(5±0.8)d,术后2例发生尿漏,3例体温在38.5度以上。术后1周复查腹部立位平片及B超,提示均无结石残留。结论:腹膜后腹腔镜输尿管切开取石术治疗嵌顿性上段输尿管结石安全、可行、有效,术中对结石的精确定位及输尿管壁的缝合技巧是手术成功的关键。Objective ：To study the clinical experiences, surgical techniques, and efficacy of retroperitoneal laparoscopic uret- erolithotomy for incarcerated upper ureteral calculi. Methods ： From Apr. 2007 to Jun. 2012, the clinical data of 55 patients （ 30 males and 25 females） who underwent retroperitoneal laparoscopic ureterolithotomy for incarcerated upper ureteral calculi were retrospectively analyzed. Mean age of the patients was （41.3 _＋ 17.5 ） years. Results：All 55 cases were operated successfully without conversion to open surgery. The mean operation time was （57.5 -＋ 22.7） rain, and mean blood loss was （ 37.5 ＋ 9.1 ） ml. The Foley catheter was re- moved 10 days after surgery. Mean postoperative hospital stay was （ 5 ＋ 0.8 ） days, with postoperative urinary leakage in 2 cases and postoperative body temperature over 38.5 degrees in 3 cases. One week after surgery, abdominal orthostatic plain film and urinary sys- tem B ultrasound showed no residual stones. Conclusions：Retroperitoneal laparoscopie ureterolithotomy for incarcerated upper ureteral calculi is feasible, safe and effective, and precise positioning of the stones and ureteral wall suture technique is the key to the success of the surgery.

关 键 词：输尿管结石 输尿管切开取石术 腹腔镜检查 腹膜后路径 手术技巧 

分 类 号：R699[医药卫生—泌尿科学]