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目的:探讨后腹腔镜输尿管上段切开取石术的技术要点及临床价值。方法:采用后腹腔镜技术行输尿管上段切开取石术46例,其中有29例有ESWL失败史。结石直径10～25 mm,平均17.5 mm。结果:46例手术全部成功。手术时间55～160 min,平均100min;术中出血20～60 ml,平均30 ml;术后无漏尿;肠功能恢复时间12～24 h;术后2～3天拔除血浆引流管;术后住院7～8天;随访25例,随访时间6～10个月,患者肾脏积水及肾功能均明显好转,无结石复发、炎性息肉及输尿管切开缝合处狭窄。结论:后腹腔镜输尿管上段切开取石术作为微创泌尿外科的手术方法,丰富了对于输尿管上段结石的治疗手段;其具有创伤小、疼痛轻、恢复快等优点;掌握好手术指征,是治疗输尿管上段结石安全有效的手术方法。
Objective: To investigate the technical points and clinical value of retroperitoneal laparoscopic ureterolithotomy. Methods: Retroperitoneoscopic laparoscopic ureteral surgery in 46 cases, including 29 cases of ESWL failure history. Stone diameter 10 ~ 25 mm, an average of 17.5 mm. Results: All the 46 surgeries were successful. The operation time was 55 to 160 minutes with an average of 100 minutes. The intraoperative bleeding was 20-60 ml (mean 30 ml). No leakage was found after operation. The recovery time of intestinal function was 12-24 hours. The drainage tube was removed 2-3 days after operation. Hospitalized 7 to 8 days; follow-up 25 cases, followed up for 6 to 10 months, patients with renal hydronephrosis and renal function were significantly improved, no recurrence of stones, inflammatory polyps and ureteral suture stenosis. Conclusions: Retroperitoneal laparoscopic ureteral incision lithotomy as minimally invasive surgical treatment of urology, which enriches the treatment of upper ureteral calculi; it has the advantages of less trauma, less pain and faster recovery; Surgical treatment of upper ureteral calculi safe and effective method.