Clinical singnificance of retroperitoneal laparoscopy for the complex proximal ureteral calculi
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摘要: 目的：探讨后腹腔镜输尿管切开取石术治疗复杂性输尿管上段结石的适应证选择及手术技巧。方法：回顾性分析2009年3月~2011年12月术前确诊为复杂性输尿管上段结石并行后腹腔镜输尿管切开取石术29例患者的临床资料。结果：29例手术均获得成功，手术时间60~180 min，平均98.6 min；术中出血20~50 ml，平均35 ml。术后无严重并发症发生。随访2~34个月，患者肾输尿管积水均明显好转，无结石复发和输尿管吻合处狭窄等并发症。结论：后腹腔镜输尿管切开取石术安全有效，可以作为体积较大、位置较低或经其他微创治疗失败的复杂性输尿管上段结石首选的治疗方法。
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关键词:
- 后腹腔镜技术 /
- 复杂性输尿管上段结石 /
- 治疗学
Abstract: Objective: To evaluate the selection of indications and surgical techniques of retroperitoneoscopic ureterolithotomy in complex proximal ureteral calculi.Method: The clinical data of 29 patients, from March 2009 to December 2011, who underwent retroperitoneal laparoscopic ureterolithotomy for the complex proximal ureteral stones were retrospectively analyzed.Result: All the 29 cases underwent retroperitoneoscopic ureterolithotomy successfully. Operative time ranged from 60 to 180 min(mean, 98.6 min). The intraoperative blood loss ranged from 20 to 50 ml(mean, 35 ml). No postoperative complications were encountered. During the follow-up period 2-34 months, no ureteric stricture or recurrent calculus had been found, hydronephrosis and hydroureterosis were lessened. Conclusion: Retroperitoneoscopic uretero-lithotomy is a safe and effective minimally invasive procedure. It may be considered as the firstline treatment in selected patients with large, low-order stones, or other complex upper ureteric stones experienced unsuccessful minimally invasive treatments. -
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