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目的 :探讨后腹腔镜输尿管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切开取石术 2 6例 ,其中 1 8例分别于术前行体外冲击波碎石术 (ESWL)、输尿管镜取石术或两者结合而失败 ,8例术前未行其他治疗 ;结石直径 1 2～ 2 5mm ,平均 1 8.5mm。结果 :1例因结石移入肾脏改行开放性手术 ,余 2 5例取石成功 ;手术时间 4 0～ 2 4 0min ,平均 70min ;术中出血量 1 0～ 5 0ml,平均 2 1 .3ml;肠功能恢复时间 1 2～ 2 4h ;术后 4d拔除腹膜后引流管 ,无漏尿 ;术后住院时间 5～ 6d ;2 1例获随访 2～ 38个月 ,所有病例肾功能均得到改善 ,无结石复发及输尿管狭窄发生。结论 :后腹腔镜输尿管切开取石术是安全有效的治疗输尿管结石的方法 ,可部分代替传统开放性手术 ,对于较大的输尿管上段结石可作为首选的治疗方法
Objective: To investigate the technical points and clinical value of retroperitoneal laparoscopic ureterolithotomy. Methods: Twenty-six patients underwent ureterolithotomy with retroperitoneal laparoscopy. Of them, 18 cases were treated with ESWL, ureteroscopic lithotripsy, or a combination of the two. No other treatment; stones diameter 1 2 ~ 2 5mm, an average of 1 8.5mm. Results: One case was transferred to the kidneys by stone open surgery, leaving more than 25 cases of stone success; operation time 40 ~ 240min, average 70min; intraoperative blood loss 10 ~ 50ml, an average of 21.3ml; intestinal function The recovery time was 12 ~ 24 hours. The retroperitoneal drainage tube was removed 4 days after operation. The postoperative hospital stay was 5 ~ 6 days. Twenty-one cases were followed up for 2 ~ 38 months. Renal function was improved in all cases without stone Recurrence and ureteral stricture. Conclusion: Retroperitoneal laparoscopic ureterolithotomy is a safe and effective method for the treatment of ureteral calculi, which can partially replace the traditional open surgery. For the larger ureteral calculi, it can be used as the first choice of treatment