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目的探讨腹腔镜下中上段输尿管切开取石术的技术、疗效和临床意义。方法2006年3月—2007年5月收治输尿管中上段结石20例,采用经腹膜后途径腹腔镜下施行输尿管中上段切开取石手术,取石后直接于镜下置入双J管,缝合输尿管切口,置输尿管旁引流管。结果20例手术均获成功,无一例中转开放性手术,手术时间30—80min,平均50min,失血30—60ml,术后次日下床活动,第2—4天拔除输尿管旁引流管,4—5天拔除导尿管,术后住院时间5—7天,3—4周膀胱镜下拔除双J管,随访3—6个月恢复良好。结论后腹腔镜下中上段输尿管切开取石术疗效好、创伤小、痛苦少、恢复快。
Objective To investigate the technique, curative effect and clinical significance of laparoscopic ureterolithotomy. Methods From March 2006 to May 2007, 20 cases of upper and middle ureteral calculi were treated by laparoscopic retroperitoneal laparoscopic surgery in the upper ureteral segment. The stone was placed directly into the double J tube under the microscope and sutured ureter incision , Set the ureteral drainage tube. Results All the 20 surgeries were successful. None of the patients underwent open surgery. The operation time was 30-80min, the average time was 50min, the blood loss was 30-60ml. The patients got out of bed the day after surgery. The ureteral drainage tube was removed 2-4 days later, 5 days removal of the catheter, postoperative hospital stay 5-7 days, 3-4 weeks of cystoscopy removed double J tube, followed up for 3-6 months recovered well. Conclusions Retroperitoneal laparoscopic ureterolithotomy has good curative effect, less trauma, less pain and rapid recovery.