后腹腔镜输尿管切开取石术治疗复杂性输尿管上段结石  

Retroperitoneal laparoscopic ureterolithotomy for complex upper ureteral calculi

作　　者：欧平[1] 邓晓洪[1] 郑军[1] 王元中[1] 陈高亮[1] 

机构地区：[1]重庆市中山医院泌尿外科,400013

出　　处：《检验医学与临床》2014年第16期2235-2237,共3页Laboratory Medicine and Clinic

摘　　要：目的：探讨后腹腔镜输尿管切开取石术（RL U ）治疗复杂性输尿管上段结石的疗效和手术技巧。方法回顾性分析2009年3月至2013年8月术前确诊为复杂性输尿管上段结石并行RL U治疗的33例患者的临床资料，其中男21例，女12例，平均年龄43岁，结石停留时间均大于8周。结果33例手术均获得成功，手术时间60～150 min ，平均90．6 min ，术中出血量约22～52 mL ，平均32 mL。15例术中发现合并输尿管息肉，同时进行处理。无严重并发症发生。术后3个月复查B超示患者肾积水消失或较术前明显减轻。所有患者均获得随访，随访3～27个月，无结石复发和输尿管狭窄等并发症发生。结论 RL U手术安全有效，可以代替传统开放手术，成为复杂性输尿管上段结石或经其他微创治疗失败患者的首选治疗方法。Objective To evaluate the efficacy and surgical techniques of retroperitoneal laparoscopic uret-erolithotomy（RLU） in the trectment of complex upper ureteral calculi .Methods The clinical data of 33 cases（21 males and 12 females） of complex upper ureteral calculi patients who underwent RLU ,from March 2009 to August 2013 ,were retrospectively analyzed .Results All the 33 cases underwent RLU successfully .Operative time ranged from 60 to 150 min（mean ,90 .6 min） .The average volume of surgical blood loss was 32 mL ,ranged from 22 to 52 mL .During the operations ,we dealed with 15 cases of ureteral calculi complicated by ureteric polyps simultaneously . No serious complications were encountered .B ultrasound after 3 months of operation showed the hydronephrosis dis-appeared or observably reduced compared with the preoperative status .During the period followed 3-27 months ,ure-teral stricture or recurrent calculus had not been found .Conclusion RLU is safe ,effective and minimally invasive procedure .It may be considered as the first-choice treatment for patients with complex upper ureteral stones or the other experienced unsuccessful minimally invasive treatments .It can replace the conventional open surgery .

关 键 词：后腹腔镜 复杂性输尿管上段结石 输尿管切开取石术 

分 类 号：R693[医药卫生—泌尿科学]