摘要
目的探讨后腹腔镜输尿管切开取石术的方法及临床应用价值。方法采用后腹腔镜技术行输尿管切开取石术32例,结石大小1.2 cm×1.5 cm～2.0 cm×3.1 cm。病程3月～2年。9例患者术前行体外冲击波碎石术(ESWL)失败;1例行输尿管镜下碎石(RUL)治疗失败;22例术前未行其他治疗。结果 32例患者后腹腔镜技术手术取石均成功。手术时间70～130min,平均85 min。手术出血量在10～20 ml,3例术后出现漏尿,6 d后尿漏消失,无其他并发症。术后住院时间5～10 d,平均6d。32例随访3～48月,患者肾输尿管积水均明显改善,无结石复发和输尿管切开缝合处狭窄。结论后腹腔镜输尿管切开取石术是安全有效的方法,可作为ESWL和URL治疗输尿管结石失败的补救措施,部分替代传统的开放手术;而对于直径>1.2cm的嵌顿性输尿管上段结石可作为首选的治疗方法。
Aim To evaluate the treatment of upper ureteral calculi by retroperitoneoscopic ureterolithotomy.Methods The clinical data of 32 cases of upper ureteral calculi were analyzed retrospectively.Retroperitoneoscopic ureterolithotomy was carried out in 9 patients after unsuccessful ESWL,1 patient after unsuccessful ureteroscopy,22 patients were treated as a primary procedure.Results All the 32 cases underwent retroperitoneoscopic ureterolithotomy successfully.During the follow-up period（3~48 months）,no ureteric stricture or recurrent calculus were found.B ultrasound and IVP examinations showed hydronephrosis were lessened.Conclusions Retroperitoneoscopic ureterolithotomy may be considered as the first choice of treatment of upper ureteral calculi（diameter of the tumor more than 12 mm）.It is safe,reliable and minimally invasive.It can partially replace conventional unsuccessful ESWL and ureteroscopy.
出处
《安徽医药》
CAS
2011年第11期1370-1371,共2页
Anhui Medical and Pharmaceutical Journal
关键词
输尿管上段结石
后腹腔镜
治疗
retroperitoneal laparoscopy
upper ureteral calculi
treatment
