3D腹腔镜在输尿管上段切开取石术中的应用  

The Application of 3D Video Techniques in Ureterolithotomy in the Treatment of Upper Ureteral Calculus

作　　者：周红庆[1] 张小德[1] 刘明生[1] 邵涛[1] 许陈祥[1] 邓体斌 吴尧[1] 

机构地区：[1]云南省曲靖市第一人民医院微创泌尿外科,云南曲靖655000

出　　处：《中国医药指南》2017年第3期2-3,共2页Guide of China Medicine

摘　　要：目的探讨3D腹腔镜下输尿管切开取石术治疗输尿管上段结石的疗效和优越性。方法分析我院2014年3月至2015年11月对42例输尿管上段(腰4椎体横突以上)结石患者行3D腹腔镜下输尿管切开取石,其中男31例,女11例,年龄25~71岁,平均46岁,右侧28例,左侧14例,对手术时间、结石取尽率、术中出血量、术后往院天数、并发症发生率等资料进行分析。结果 42例手术均1次成功取出结石,平均手术时间74 min,净石率97.7%,出血量10~50 mL(平均26 mL),术后住院时间4~10 d(平均7 d),无术后漏尿、输尿管狭窄等严重并发症,1例术中输尿管结石部分上移,术后经体外冲击波碎石后结石排出,术后随访2个月~1年,无输尿管狭窄等并发症。结论 3D腹腔镜下输尿管上段切开取石术治疗输尿管上段结石安全、有效、并发症低,同时手术中解剖层次分明、缝合简单,是治疗输尿管上段结石较好术式。Objective To explore the values and advantages of using 3D imaging system in laparoscopic ureterolithotomy in the treatment of upper ureteral calculus. Methods From March 2014 to November 2015, a total of 42 cases of upper ureteral calculus were completed ureterolithotomy by using Viking 3D HD laparoscopy system. 31 patients were male and 11 were femal, the age was 25-71 years, with the average age of 46 years, 14 cases in the leit and 28 cases in the right. The operation time, bleeding volume, inpatient time, complications were analyzed. Results All the surgeries were successful except 1 case, of which part of stones moved to the kidney, which was cuved by Extracorporeal shockwave lithotripsy after the operation. The surgery time was 58-176 min （with the average of 74 rain）, The stone clearance rate was 97.7% （41/42）, The blood loss was 10-50 mL（with the average of 26 mL）. and the postoperative hospital time was 4-10 d, with an average of 7 d. All patients were followed up for 2-12 months, no severe complications occured, such as urine leakage, stricture of ureter and so on. Conclusions The laparoscopic ureterolithotomy for upper ureteral calculus using 3D imaging system has advantages of safe and efficiency, lower of complications and fast recovery, morever, it has advantages of accurate anatomy and simple of suture. It could provide a better laparoscopic surgery.

关 键 词：3D腹腔镜 输尿管切开取石术 输尿管上段结石 

分 类 号：R691.4[医药卫生—泌尿科学]