后腹腔镜输尿管切开取石术治疗输尿管上段嵌顿性结石

Retroperitoneal Laproscopic Ureterolithotomy for the Impacted Upper Ureter Calculi

摘要: 后腹腔镜，输尿管切开取石术，输尿管结石目的：评价后腹腔镜输尿管切开取石术(RLUL)治疗输尿管上段嵌顿性结石的安全性和有效性。方法：回顾分析2013年1月~2016年12月采用RLUL术治疗的40例输尿管上段嵌顿性结石，对手术方法、治疗效果及并发症进行系统分析。结果：所有病例均顺利取出结石：手术时间(76.5 ± 21.3) min、术中失血量(35.6 ± 9.8) ml、术后肠道恢复时间(19.2 ± 7.4) h、术后住院时间(8.6 ± 1.3) d，无漏尿、感染、输尿管狭窄等并发症发生。结论：RLUL术治疗嵌顿性输尿管嵌顿性上段结石疗效确切、安全性高，术中对结石的定位及输尿管切口的缝合是手术的关键。

Abstract: Objective: To assess the safety and efficacy of retroperitoneal laparoscopic ureterolithotomy (RLUL). Methods: From January of 2013 to December of 2016, 40 patients with calculus in the impacted upper ureter were treated with RLUL; the surgical methods, treatment effects and complications were systematically analyzed. Results: All the operations were successful with complete stone clearance. The operative time, intraoperative blood loss, mean postoperative intestinal function recovery time and mean postoperative hospital stay was (76.5 ± 21.3) min, (35.6 ± 9.8) ml, (19.2 ± 7.4) h, (8.6 ± 1.3) d respectively. Follow-up was ranged from 3 to 18 months; no major postoperative complication occurred. Conclusions: RLUL for impacted upper ureteral calculi is feasible, safe and effective, and precise positioning of the stones and ureteral wall suture technique is the key to the success of the surgery.