双镜联合治疗下腔静脉后输尿管并右肾结石二例报道并文献复习  

Retroperitoneal laparoscopy combined with flexible ureteroscopy for the treatment of retrocaval ureter and right kidney stones:2 case reports and review of the literature

作　　者：延敏博[1] 楚溪 黄书畅 郭振宇[1] 汤育新 戴英波 Yan Minbo;Chu Xi;Huang Shuchang;Guo Zhenyu;Tang Yuxin;Dai Yingbo(Department of Urology,the Fifth Affifiliated Hospital of Sun Yat-sen University,Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院泌尿外科,珠海519000

出　　处：《中华腔镜泌尿外科杂志（电子版）》2020年第6期469-472,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的报道双镜联合治疗下腔静脉后输尿管并右肾结石的初步经验,探讨其手术技巧及临床疗效。方法回顾分析2例下腔静脉后输尿管并右肾结石患者的诊治资料,2例患者行CT尿路成像(CTU),右侧输尿管均呈典型S型改变,且合并右肾结石。手术方式均为腹腔镜下腔静脉后输尿管矫形,联合输尿管软镜碎石取石术。结果2例患者诊断明确,术程顺利,无中转开放,手术时间分别为:115 min、108 min;术中出血分别为:30 ml、20 ml;均于术后第1天恢复肠道功能,术后第3天拔除右肾周引流管,术后复查腹部平片(KUB)均示右输尿管内双J管位置正常,右肾无结石残留,术后第5天出院,术后1个月拔除双J管。结论腹腔镜联合输尿管软镜治疗下腔静脉后输尿管并右肾结石安全、高效,可作为该疾病的首选手术方式。Objective To report the preliminary experience of retroperitoneal laparoscopy combined with flexible ureteroscopy for the treatment of retrocaval ureter and right kidney stones,and explore the surgical skills and clinical efficacy.Methods The therapeutic strategy of two patients with retrocaval ureter and right kidney stones was reported and analyzed.In the CT urography of two patients,the right ureter showed a typical S-type change combined with right kidney stones.These patients were underwent retroperitoneal laparoscopic ureteroplasty and flexible ureteroscopic lithotripsy.Results Two patients were diagnosed clearly and the procedures were successful.There was no conversion to open surgery,the operation time was 115 min and 108 min respectively.The intraoperative blood loss was 30 ml and 20 ml respectively.The intestinal function was restored on the first postoperative day.The right perirenal drainage tubes were removed on the third day after the operation.There was no residual stone in right kidney,and the double J stents were in normal position showed by KUB.The patients were discharged on the 5th day and the stents were removed in one month after operation.Conclusions Retroperitoneal laparoscopy combined with flexible ureteroscopy should be considered to be the first-line treatment for retrocaval ureter and right kidney stones.

关 键 词：腹腔镜 输尿管软镜 下腔静脉后输尿管 肾结石 

分 类 号：R699[医药卫生—泌尿科学]