后腹腔镜肾盂输尿管切开取石术的疗效观察

目的:探讨后腹腔镜肾盂输尿管切开取石术的技术与临床价值。方法:采用后腹腔镜技术行肾盂输尿管切开取石术24例,术前未行其他治疗。结果:24例均取石成功,其中1例5岁患儿改开放手术留置输尿管支架外引流管;手术时间55～210min,平均103min;术中出血量5～30ml,平均17.5ml。术后肠功能恢复时间12～24h,漏尿时间0～3d,日漏尿量0～50ml。术后4d拔除腹膜后引流管;术后住院5～7d;20例获随访2～12个月,患者肾功能均得到改善,无肾盂输尿管狭窄发生。结论:后腹腔镜肾盂输尿管切开取石术具有创伤小、患者康复快、疼痛轻等优点,是微创治疗上尿路结石可选择的方法,对于较大的肾外型肾盂、输尿管上段结石可作为首选的治疗方法。

Effect of retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy

Objective:To review the technique of retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy and evaluate its clinical effect.Methods: Retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy was carried out in 24 patients,who had not received other treatment.Results: All the patients were successfully done except that one case was converted to open operation with a drain out of ureteric stand.The operation time ranged from 55 to 210 minutes,the blood loss ranged from 5 to 30ml,the time on leakage of urine ranged from 0 to 3 days with a dose of 0 50ml per day,the postoperative stay in hospital ranged from 5 to 7 days.During the followup for 20 cases,there was no ureteric stricture,and all patients’ renal function had been improved.Conclusions: The retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy has the advantages of less trauma and pain,and rapid recovery,and it is a selective microinvasive method for the treatment of ureferal calculi.Refer to large chronically impacted pelvis and upper ureteric stones,it may be considered as the firstline treatment.