双J管置入器在腹腔镜上尿路切开取石术中的应用  

Application of double-J stent inserter in laparoscopic pyelolithotomy/ureterolithotomy for upper urinary tract calculi

作　　者：钟辛[1] 江波[1] 邹晓峰[1] 袁源湖[1] 肖日海[1] 张国玺[1] 伍耿青[1] 王晓宁[1] 薛义军[1] 刘佛林[1] 刘全亮[1] 徐瑞权[1] 徐刚[1] 肖观称 夏维[1] 黄若辉 康欢[1] 

机构地区：[1]赣南医学院第一附属医院泌尿外科,江西省尿路结石现代治疗中心,江西赣州341000

出　　处：《临床泌尿外科杂志》2013年第12期903-905,909,共4页Journal of Clinical Urology

基　　金：江西省"赣鄱英才555工程"领军人才培养计划项目;江西省科技厅重大科技支撑计划项目(编号20121BBG70032);江西省教育厅科技落地计划项目(编号KJLD12044);江西省卫生厅重大科技计划项目(编号20104008)

摘　　要：目的：评价腹腔镜输尿管双J管置入器对腹腔镜上尿路切开取石术中双J管置人时间的影响，探讨其在腹腔镜上尿路切开取石术中的应用价值。方法：应用自主研发的腹腔镜输尿管双J管置入器施行腹腔镜上尿路切开取石术30例（A组），其中后腹腔镜术（RPL）（A1组）和耻骨上辅助经脐单孔腹腔镜术（SA—I。ESS）（A：组）各15例。男18例，女12例。年龄18～51岁，平均38．6岁。肾盂结石4例，输尿管上段结石21例，输尿管中段结石5例。左侧17例，右侧13例。未使用双J管置入器施行腹腔镜上尿路切开取石术30例（B组），其中RPL（B，组）和SA-LESS（B。组）各15例。男20例，女10例。年龄21～56岁，平均36．8岁。肾盂结石3例，输尿管上段结石23例，输尿管中段结石4例。左侧14例，右侧16例。比较两组术中放置双J管的时间。结果：A、B两组手术均顺利完成，60例60侧结石均一次取净。术中术后无输尿管切开处断裂及腹腔脏器损伤、大出血、漏尿等并发症发生。术中放置双J管时间：A组2～8min，平均3．4min；其中A。组2～6min，平均3．1min；A。组2～8min，平均3．8min。B组6～22min，平均11．4min；其中B1组6～18min，平均10．2min；B2组6～22min，平均12．8min。两两比较，A组〈B组，Al组〈B1组，A2组〈B：组（P〈0．05）。结论：自主研发的腹腔镜输尿管双J管置人器使用安全、简便，可以显著降低腹腔镜下放置双J管的难度，缩短置管时间，尤其适用于腹腔镜技术初学者。Objective：To evaluate the effect and significance of the application of double-J stent inserter in lapa- roscopic pyelolithotomy/ureterolithotomy for upper urinary tract calculi. Method： A total of 30 patients （Group A）, including 12 females and 18 males, underwent laparoscopic pyelolithotomies/ureterolithotomies with the help of the self-developed double-J stent inserter. The mean age of these patients was 38. 6 （range, 18-51） years. There were four patients with stones in the renal pelvis, 21 in the upper ureter and five in the middle ureter in Group A, in which, 15 patients underwent retrolaparoscopic pyelolithotomies/ureterolithotomies （Group A1 ）, and the other 15 underwent suprapubic-assisted laparoendoscopic single-site surgeries （Group A2 ）. Another 30 pa- tients （Group B）, including 10 females and 20 males, underwent laparoscopic pyelolithotomies/ureterolithotomies （16 right, 14 left） without using the self-developed double-J stent inserter. The mean age of these patients was 36.8 （range, 21-56） years. There were three patients with stones in the renal pelvis, 23 in the upper ureter and four in the middle ureter in Group B, in which, 15 patients underwent retrolaparoscopic pyelolithotomies/uret- erolithotomies （Group BI ）, and the other 15 underwent suprapubic-assisted [aparoendoscopic single-site surgeries （Group B2）.We compared the time for double-J stent placement between Group A and Group B.Result：

关 键 词：上尿路结石 双J管置入器 腹腔镜术 

分 类 号：R691.4[医药卫生—泌尿科学]