【摘要】 目的 总结后腹腔镜下输尿管切开取石术的经验并评价其在临床应用中的效果。方法 对36例后腹腔镜下输尿管切开取石术患者进行回顾性分析，其中男22例，女14例，年龄14～58岁，平均37岁。左侧18例，右侧16例，双侧2例，均为中上段结石，长径约0.9～2.5 cm。结果 所有患者均取石成功，手术时间为50～240 min，术中出血15～60 ml,平均30 ml，术后随访肾积水及肾功能均明显好转。结论 腹膜后腹腔镜下输尿管切开取石术具有安全有效、创伤小、恢复快、痛苦小的优点，可以作为替代体外冲击波碎石(extracorporeal shock wave lithotripsy,ESWL)和输尿管镜下碎取石术失败的一种微创手术方法。
【关键词】 输尿管结石;后腹腔镜
Clinical significance of retroperitoneoscopic ureterolithotomy
LIU Jinkun1, GAO Xianhua1, WANG Zonglei1, HAN Conghui2*
(1. Department of Urology, The People′s Hospital of Feng County, Feng County, Jiangsu 221700, China;
2. Department of Urology, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009)
Abstract: Objective To explore the technical key points and the therapeutic efficacy of retropenitoneal laparoscopic ureterolithotomy and the treatment of combined disease. Methods The clinical data of 36 cases (22 males and 14 females) of retroperitoneoscopic ureterolithotomy were retrospectively analyzed. Their age ranged from 14 to 58 years (mean=37yrs). The calculi were found in left side in 18 cases, in right side in 16 cases and on both sides in 2 cases. The calculi were 0.9 to 2.5 cm in diameters. Results All the stones were completely removed by single procedure. The operation was between 50 and 240 min, with blood loss of about 15-60 ml (mean=30 ml). Conclusions Retroperitoneoscopic ureterolithotomy has advantages of being minimal invasive, safe and effective, shortened postoperative recovery and reduced hospital stay. It could serve as an alternative remedy for the failure in ESWL or ureteroscopic lithotripsy in the urologic clinical practice.
Key words: ureteral calculi; retrolaparoscope
随着腹腔镜技术在泌尿外科应用的不断成熟和适应证的扩大，后腹腔镜下输尿管切开取石术这种新的微创手术方法近几年来也越来越多地应用于临床。2003年9月—2007年2月，我科共治疗36例中上段输尿管结石，并取得较好效果，现报道如下。
1 资料和方法
1.1 一般资料 本组36例患者，男22例，女14例，年龄14～58岁，平均37岁。左侧18例，右侧16例，双侧2例。均为中上段结石，大小长径约0.9～2.5 cm，病程1个月～8年，均伴有患侧中度到重度肾积水，其中2例合并同侧肾囊肿，同时予以肾囊肿
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