Objective To discuss the best surgical treatment for impacted upper and middle ureteral calculi. Methods A retrospec-tive analysis was made to the clinical data of 23 cases with upper and middle ureteral calculi,who received retroperitoneal laparoscopic ureterolithotomy via straight incision in my hospital from Aug.,2006 to April,2013,14 male and 9 female with the average age of 43 years old;6 cases were operated on the left side,9 cases on the right side and 8 cases on both sides. Results The calculi with the diame-ter from 1.0cm to 3.5cm were all removed,the operations took from 40 to 120 minutes;the bleeding in operation was much less;pa-tients started walking on the next day of operation;no occurrence of retroperitoneal hematoma or urine leakage was found;1 case with incision infection healed after dressing changes;post-operative follow-up lasted from 6 months to more than 7 years,no complications occurred. Conclusions Retroperitoneal laparoscopic ureterolithotomy via straight incision is safe,easy-operated and effective for upper and middle ureteral calculi.%目的：探讨输尿管中上段嵌顿结石的终极外科治疗手段。方法回顾性分析自2006年8月~2013年4月在我院接受经背部直切口辅助后腹腔镜行中上段输尿管切开取石23例患者的临床资料。其中男14例，女9例，平均43岁，左侧6例，右侧9例，双侧8例。结果输尿管中上段结石直径1.0~3.5cm，手术时间40~120min，术中失血量极少，术后翌日即下床活动，无腹膜后血肿，无尿漏，1例切口感染换药处理愈合。术后随访6月至7+年，无并发症。结论经背部直切口辅以腹腔镜行输尿管中上段切开取石术式安全、简捷、有效。
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