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目的:探讨后腹腔镜输尿管切开取石术治疗嵌顿性输尿管结石的临床价值和技术要点。方法:2006年12月至2009年3月,对58例嵌顿性输尿管中上段结石采用后腹腔镜输尿管切开取石术,术中取石后于镜下直接置入双J管,间段缝合输尿管切口。结果:58例手术均获成功,无中转开放手术,结石清除率100%。术后创腔引流液量少,3～5d拔除引流管,1周出院,术后3周膀胱镜下拔除双J管。随访1～27个月,B超复查显示肾积水明显好转或消失,无结石复发。结论:后腹腔镜输尿管切开取石术治疗嵌顿性输尿管结石具有创伤小疗效好、术后恢复快等特点,明显优于开放手术及其它手术,值得推广应用。
Objective: To investigate the clinical value and technical points of laparoscopic ureterolithotomy in the treatment of incarcerated ureteral calculi. METHODS: From December 2006 to March 2009, 58 cases of upper ureteral calculi with ureteral calculi underwent retroperitoneal laparoscopic ureterolithotomy. The stones were directly placed into the double J tube under the microscope and the ureter incision. Results: All the 58 surgeries were successful. There was no transfer to open surgery and the rate of stone removal was 100%. Drainage fluid volume less postoperative drainage, drainage tube 3 ~ 5d, 1 week after discharge, 3 weeks after cystoscopy removed double J tube. Follow-up 1 to 27 months, B-ultrasound showed significant improvement or disappearance of hydronephrosis, no recurrence of stones. Conclusions: Retroperitoneoscopic laparoscopic ureterolithotomy for the treatment of incarcerated ureteral calculi has the advantages of small trauma, good curative effect and quick recovery after operation. It is obviously superior to open surgery and other surgeries and is worth popularizing and applying.