腹腔镜经肠系膜途径输尿管切开取石术治疗输尿管中上段结石68例疗效观察  

Efficacy of laparoscopic ureterolithotomy by transmesenteric approach in the treatment of 68 cases of middle and upper ureteral calculi

作　　者：李江松[1] 赵凯[2] 靳月丽 孙茸[1] 闫慧磊 马征[1] 黄官礼[1] 赵伟[1] 周士明[1] 曹龙滨[1] LI Jiang-song;ZHAO Kai;JIN Yue-li;SUN Rong;YAN Hui-lei;MA Zheng;HUANG Guan-li;ZHAO Wei;ZHOU Shi-ming;CAO Long-bin(Liaocheng People's Hospital,Liaocheng 252000;Gaotang People's Hospital,Gaotang 252800,China)

机构地区：[1]聊城市人民医院,山东聊城252000 [2]高唐县人民医院,山东聊城252800

出　　处：《现代泌尿外科杂志》2020年第7期627-630,共4页Journal of Modern Urology

摘　　要：目的探讨腹腔镜经肠系膜途径输尿管切开取石术治疗中上段输尿管结石临床应用价值。方法回顾地分析2016年1月至2019年3月腹腔镜下经肠系膜途径治疗的68例输尿管中上段结石患者临床资料。记录患者的性别、年龄、手术时间、术中出血量、术后肠道恢复时间,术后症状改善和B超复查结果。结果67例手术取石顺利,有1例结石上行到肾盂而行体外冲击波碎石治疗。手术时间(41.2±4.7)min,术中出血量(5.3±1.6)mL,术后肠道恢复时间(9.5±2.1)h。68例患者随访1~36个月,全部患者肾输尿管积水明显好转,无结石复发和输尿管切开缝合处狭窄。结论对体形瘦、肠系膜脂肪少的中上段输尿管结石患者,腹腔镜经结肠系膜途径输尿管切开取石安全有效,可以减少创伤、缩短肠道恢复及手术时间。Objective To explore the application value of laparoscopic ureterolithotomy by transmesenteric approach in the treatment of middle and upper ureteral calculi.Methods Clinical data of 68 ureterolithiasis patients who underwent laparoscopic ureterolithotomy by transmesenteric approach during Jan.2016 and Mar.2019 were retrospectively analyzed,including patients'gender,age,operation time,intraoperative blood loss,postoperative intestinal recovery time,postoperative symptom improvement and B ultrasound results.Results All operations were successful,and 1 case converted to extracorporeal shock wave lithotripsy for calculi ascended to the renal pelvis.The operation time was(41.2±4.7)min,intraoperative blood loss was(5.3±1.6)mL,and postoperative intestinal recovery time was(9.5±2.1)h.During the follow-up of 1-36 months,hydronephrosis was significantly improved in all patients,and no recurrence of calculi or stenosis of ureter occurred.Conclusion Laparoscopic ureterolithotomy by transmesenteric approach is safe and effective in the treatment of middle and upper ureteral calculi in patients with thin body and little mesenteric fat.It can reduce trauma,shorten intestinal recovery and operation time.

关 键 词：腹腔镜 输尿管结石 输尿管切开取石术 

分 类 号：R699.4[医药卫生—泌尿科学]