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目的总结后腹腔镜切开取石术治疗复杂性输尿管上段结石的手术效果和经验。方法回顾性分析56例复杂性输尿管上段结石患者行后腹腔镜切开取石术的临床资料。结果 56例患者后腹腔镜切开取石术手术均获成功,结石完整取出,术中无周围器官、血管损伤,无术中、术后大出血。手术时间56~102min;术中出血10~55ml。术中见输尿管壁肿胀明显,部分有炎性息肉包裹。术中发生腹膜破损1例,术后漏尿1例,持续2d,无严重并发症发生。术后随访3~12个月,肾、输尿管积水均明显好转,无结石复发和输尿管切开处狭窄。结论后腹腔镜输尿管切开取石术可安全、有效地治疗复杂性输尿管上段结石。手术操作创伤小、手术时间短、术后康复快,可作为治疗复杂性输尿管上段结石的常规方法。
Objective To summarize the surgical results and experience of retroperitoneoscopic laparoscopic lithotripsy in the treatment of complex upper ureteral calculi. Methods Retrospective analysis of 56 cases of complicated upper ureteral calculi in patients with laparoscopic removal of the clinical data. Results All 56 patients underwent laparoscopic laparotomy and surgery were successfully performed. The stones were completely removed without peripheral organs and blood vessel injury during surgery. There was no intraoperative or postoperative bleeding. Operation time 56 ~ 102min; intraoperative bleeding 10 ~ 55ml. Ureteral wall surgery see swelling obvious, some inflammatory polyps wrapped. Intraoperative peritoneal damage in 1 case, postoperative leakage of urine in 1 case, continued 2d, no serious complications. All the patients were followed up for 3 to 12 months. Renal and ureter hydronephrosis were all improved obviously. No recurrence of stones and stenosis of ureteral incision were observed. Conclusions Retroperitoneal laparoscopic ureterolithotomy can safely and effectively treat complex upper ureteral calculi. Surgical trauma, short operative time, fast recovery, can be used as a routine treatment of complex upper ureteral calculi.