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目的 :介绍腹腔镜输尿管切开取石术的技术要点和初步经验。方法 :腹腔镜输尿管切开取石术治疗输尿管中、上段结石 18例 ,KUB上结石影最大为 2 .0 cm× 1.5 cm,最小 0 .8cm× 0 .6 cm,平均 1.3cm× 0 .9cm。经腹腔途径手术 10例 ,经腹膜后途径 8例。结果 :18例取石全部成功。手术时间平均 16 5 min。术后住院平均 4 .9d。主要并发症有漏尿 1例 ,开放手术留置双 J管后治愈。平均随访 8.0个月 ,未发现输尿管狭窄。结论 :腹腔镜输尿管切开取石术疗效确切 ,比开放取石术损伤小 ,康复快 ,为输尿管结石治疗提供了新的选择。
Objective: To introduce the technical points and preliminary experience of laparoscopic ureterolithotomy. METHODS: Laparoscopic ureterolithotomy was performed in 18 cases of upper and middle ureteral calculi. The maximum lithotripsy on KUB was 2.0 cm × 1.5 cm and the smallest was 0.8 cm × 0.6 cm with an average of 1.3 cm × 0.9 cm. Ten cases were treated by intraperitoneal route and 8 cases were treated by retroperitoneal approach. Results: 18 cases of stone were all successful. The average operation time was 16 5 min. The average postoperative hospital stay was 4.9 days. The main complications were leakage of urine in 1 case, open surgery after double J tube cured. With an average follow-up of 8.0 months, no ureteral stricture was found. Conclusions: Laparoscopic ureterolithotomy has definite curative effect, less injury and quick recovery than open lithotomy, which provides a new choice for the treatment of ureteral calculi.