论文部分内容阅读
目的探讨后腹腔镜下输尿管切开取石治疗复杂性上尿路结石的技术特点和临床应用价值。方法对收治的20例复杂性上尿路结石(结石梗阻时间长,肾积水重,结石周围形成黏连包裹者)病人行后腹腔镜输尿管切开取石术,其中16例术前曾行体外震波碎石(ESWL)治疗。病程最长达3年,结石直径0.7-3.5cm。术中均放置双“J”管和后腹腔引流管。结果后腹腔镜下完成手术14例,中转开放手术6例。全部病例均治愈。后腹腔镜手术平均住院时间(9.4d)小于中转开放手术(16.3d),P<0.05。随访3-22个月,B超和(或)静脉肾盂造影(IVU)复查结石无复发,原有肾积水减轻或消失。结论后腹腔镜输尿管切开取石术具有创伤小,恢复快,住院时间短及结石复发率低的特点,可作为复杂性上尿路结石的首选术式。
Objective To investigate the technical characteristics and clinical value of retroperitoneoscopic ureterolithotomy in the treatment of complex upper urinary tract calculi. Methods Twenty patients with complicated upper urinary tract calculi (long stone obstruction, severe hydronephrosis, adhesions and entrapment around the stones) underwent laparoscopic ureterolithotomy, of whom 16 had preoperative and ex vitro Shock wave lithotripsy (ESWL) treatment. The course of up to 3 years, 0.7-3.5 cm diameter stones. Surgery are placed double “J ” tube and retroperitoneal drainage tube. Results Laparoscopic surgery completed in 14 cases, 6 cases of open surgery. All cases were cured. The average length of postoperative laparoscopic surgery (9.4 days) was shorter than that of open surgery (16.3 days), P <0.05. All the patients were followed up for 3-22 months. No recurrence was found in B-ultrasound and / or IVU. The original hydronephrosis was reduced or disappeared. Conclusions Retroperitoneal laparoscopic ureterolithotomy has the characteristics of small trauma, fast recovery, short hospital stay and low recurrence rate of stones, which can be used as the first choice for the complicated upper urinary tract calculi.