论文部分内容阅读
目的:探讨后腹腔镜输尿管切开取石术治疗大体积输尿管上段结石的可行性、有效性及临床经验。方法:对7例大体积输尿管上段结石的患者行后腹腔镜输尿管切开取石术,结石长径36~60mm,平均49mm,患侧均伴有不同程度的肾盂积水,中度1例,重度6例。结果:7例手术均一次性取石成功,手术时间55~130min,平均(70.0±18.5)min,术中出血20~120ml,平均(40.0±23.5)ml,术后住院4~7d,尿管保留7d,双J管1个月后拔除。随访3~36个月,1例患者发生切口感染延迟愈合,无漏尿、输尿管狭窄等并发症,无结石复发。结论:该方法安全可行、疗效确切,具备良好腹腔镜下分离、缝合技巧的术者可将其作为首选治疗方法。
Objective: To investigate the feasibility, effectiveness and clinical experience of retroperitoneal laparoscopic ureterolithotomy for massive ureteral calculi. Methods: Seven patients with massive ureteral calculi underwent retroperitoneoscopic laparoscopic ureterolithotomy. The major diameter of the stones was 36-60 mm (average 49 mm). The ipsilateral calculi was associated with varying degrees of hydronephrosis and moderate to severe 6 cases. Results: The operation was successful in all 7 cases. The operation time ranged from 55 to 130 minutes (mean, 70.0 ± 18.5) min. The intraoperative bleeding ranged from 20 to 120 ml, with an average of (40.0 ± 23.5) ml and postoperative hospital stay from 4 to 7 days. 7d, double J tube removed after 1 month. Followed up for 3 to 36 months, delayed incision infection occurred in 1 patient, no leakage of urine, ureteral stricture and other complications, no recurrence of stones. Conclusion: This method is safe and feasible, and the curative effect is accurate. Patients who have good laparoscopic separation and suture skills can be regarded as the preferred treatment method.