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目的探讨后腹腔镜输尿管中上段切开取石术的技术要点及临床应用价值。方法对2009年1月至2012年9月经后腹腔镜输尿管切开取石的86例患者的临床资料,包括结石及术前治疗情况、输尿管病变情况、围手术期间的并发症及预后结果进行回顾性分析。结果手术时间45～135(平均65)min,术中出血量5～30(平均10)mL,无转开放者,无漏尿、无结石残留及其他围手术期并发症。结石清除率100%,1例出现皮下气肿,24h内自行消失,所有患者症状消失,随访3～44月,无梗阻和狭窄再形成,无结石复发,输尿管扭曲消失。结论后腹腔镜输尿管中上段切开取石术效果确切,损伤小,患者术后恢复快,安全可行。
Objective To investigate the technical points and clinical value of retroperitoneal laparoscopic ureterolithotomy. Methods The clinical data of 86 patients who underwent laparoscopic ureterotomy from January 2009 to September 2012 were retrospectively reviewed, including the treatment of stone and preoperative treatment, ureteral lesions, perioperative complications and prognosis analysis. Results The operative time ranged from 45 to 135 (average 65) min. The intraoperative blood loss was from 5 to 30 (average 10) mL. There was no leakage of urine, no residual stones and other perioperative complications. Stone clearance rate of 100%, 1 case of subcutaneous emphysema disappeared within 24h, all patients disappeared symptoms were followed up for 3 to 44 months, no obstruction and stenosis re-formed, no recurrence of stones, ureteral distortion disappeared. Conclusions Retroperitoneal laparoscopic ureteral incision lithotomy is effective, less damaging and the patients recover quickly and safely.