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目的:分析后腹腔镜输尿管切开取石术手术并发症的原因,探讨其预防方法,进一步提高手术的安全性。方法:2005年6月～2010年2月采用后腹腔镜输尿管切开取石术治疗输尿管上段结石患者409例,统计其并发症发生类型,分析发生原因。结果:术中及术后发生并发症39例,其中术中并发症12例:因结石移位及局部粘连中转开放7例,血管损伤4例,输尿管横断1例;术后并发症27例:尿漏10例,切口感染2例,结石残留2例,皮下气肿10例,输尿管狭窄3例,其中需要再次手术者7例。结论:后腹腔镜输尿管切开取石术手术并发症的发生主要与手术适应证的选择、手术操作、术中输尿管的切开方式及输尿管支架管的正确放置有关;选择合适的病例、仔细正确的手术操作才能减少手术并发症的发生。
Objective: To analyze the causes of postoperative complications of laparoscopic ureterolithotomy and explore its preventive methods to further improve the safety of surgery. Methods: From June 2005 to February 2010, 409 cases of upper ureteral calculi were treated by retroperitoneal laparoscopic ureterolithotomy. The types of complications were analyzed and the causes were analyzed. Results: There were 39 cases of intraoperative and postoperative complication, including 12 cases of intraoperative complications: 7 cases of stone metastasis and local blockage, 4 cases of vascular injury and 1 case of ureter transection; 27 cases of postoperative complications: Urine leakage in 10 cases, incision infection in 2 cases, residual stones in 2 cases, subcutaneous emphysema in 10 cases, ureteral stricture in 3 cases, of which need to re-operation in 7 cases. Conclusions: The complications of retroperitoneal laparoscopic ureterolithotomy are mainly related to the choice of surgical indications, surgical procedures, intraoperative ureteral incision and the correct placement of ureteral stents. Choosing the right cases and carefully Surgical procedures can reduce the incidence of surgical complications.