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目的探讨后腹腔镜下肾盂输尿管切开取石术治疗肾盂、输尿管结石的临床疗效。方法经腹膜后腹腔镜下行肾盂输尿管切开取石术,同时切除合并的息肉。术中均放置输尿管支架管并缝合输尿管。结果52例手术均成功,取净结石,无一例中转开放手术。手术时间50～200min,平均110min。住院时间5～14d,平均7.5d。术后8周拔出支架管。52例随访6个月:术后3个月超声检查,21例肾积水消失;术后6个月超声示共32例肾积水消失,结石无复发;ECT示8例重度积水肾脏的肾小球滤过率由术前平均16ml/min升高到平均25ml/min。结论后腹腔镜下肾盂输尿管切开取石术效果确切,创伤小,术后恢复快,是治疗肾盂及输尿管上段结石的有效术式之一。
Objective To investigate the clinical effect of retroperitoneoscopic ureteropelvic lithotripsy in the treatment of renal pelvis and ureteral calculi. Methods Laparoscopic retroperitoneal ureteropelvic lithotomy was performed, while the combined polyps were excised. Intraoperative ureter stent tube placed and suture ureter. Results 52 cases of surgery were successful, take net stones, no case of transfer to open surgery. Surgery time 50 ~ 200min, an average of 110min. Hospitalization time 5 ~ 14d, an average of 7.5d. Remove the stent tube 8 weeks after operation. 52 cases were followed up for 6 months: ultrasonography was performed 3 months after operation and disappearance of hydronephrosis was found in 21 cases. Hydronephrosis disappeared in 32 cases 6 months after operation, and no recurrence of stones was found. ECT showed 8 cases of severe hydronephrosis Glomerular filtration rate increased from an average of 16 ml / min preoperatively to an average of 25 ml / min. Conclusions Retroperitoneoscopic laparoscopic ureteropelvic lithotripsy is effective and has less trauma and faster postoperative recovery. It is one of the effective procedures for the treatment of upper pelvis and ureter stones.