摘要
目的 :探讨后腹腔镜输尿管切开取石术治疗输尿管上段结石的临床效果。方法 :将2014年8月至2016年6月皖南医学院附属弋矶山医院泌尿外科收治的25例输尿管上段结石患者作为研究对象。对这些患者施行后腹腔镜输尿管切开取石术,并分析其手术效果。结果 :对这25例患者进行手术治疗均获成功,其输尿管结石均一次性取净,均未中转开放式手术。这些患者平均的手术时间为(122±48)min,其平均术中的出血量为(42±10)ml。在这些患者中,有2例患者因发生漏尿而在术后留置腹膜后引流管13~15d,其余患者均在术后4~10d拔除引流管,在术后4~6周经膀胱镜拔出双J管。这些患者平均术后住院的时间为(9.1±2.9)d。在术后对这些患者随访1~6个月,发现其腰痛、发热等症状完全缓解,经B超检查显示其肾积水好转或消失,未出现输尿管狭窄和结石复发的情况。结论 :对输尿管上段结石患者施行后腹腔镜输尿管切开取石术可取得理想的效果。
Objective ： To evaluate effect of retroperitoneal laparoscopic ureterolithotomy for the treatment of upper ureteric calculi. Method ： Select from Department of Urology in Yijishan Hospital of Wannan Medical College from April 2013 to April 2014 received for upper ureteric calculi in 25 cases for research object. Treat these patients with retroperitoneal laparoscopic ureterolithotomy and observe curative effect after operation. Results： Retroperitoneal laparoscopic ureterolithotomy was performed successfully on all 19 patients, all the stones were removed completely.The operation time was （55 ~ 300）min, mean （122 ~ 48 ）rain; the blood loss during operation was（25 - 60 ml）ml, mean （42 ~ 10）min. The drainage tube replacement time was 4 ~ 10 days except 2 patients, the 2 patients replaced drainage tube in 13-15 days after operation and replaced double-J catheters in 4-6 weeks after operation. The post-operative hospital stay was7-18 days, mean（9.1 ±2.9）days. In 1~6 months follow up time to the patients after operation, we found the symptoms of low back pain, fever were eased. Ultrasonic scanning showed hydronephrosis of patients were reduced or disappeared, no calculus recurrence and ureteral stricture occurred. Conclusion Retroperitoneal laparoscopic ureteralithotomy for the treatment of upper ureteric calculi is significantly effective.
关键词
后腹腔镜
输尿管上段结石
retroperitoneal laparoscope
upper ureteric calculi
