目的:探讨腹膜后腹腔镜输尿管切开取石术治疗输尿管上段结石的临床应用价值.方法:回顾分析香港大学深圳医院2013年3月~2015年9月接受腹膜后腹腔镜输尿管切开取石术治疗的51例输尿管上段结石患者临床资料.结果:50例手术顺利,手术时间78~304 min,平均(168.4±53.4)min,术中有1例结石上行到肾盂而置管行体外冲击波碎石治疗.1例术后出血1 600 ml,经过输血等保守治疗后痊愈,1例输尿管支架管未能置入膀胱,后在输尿管镜下调整支架管位置.51例随访1~30个月,51例肾输尿管积水明显好转,无结石复发和输尿管切开缝合处狭窄.结论:腹膜后腹腔镜输尿管切开取石术治疗输尿管中上段结石,具有安全、并发症少、疗效确切等优点,远期疗效需要进一步随访.%Objective: To evaluate the clinical efficacy of retroperitoneal laparoscopic ureterolithotomy in patients with upper ureteral calculus.Methods: Fifty-one cases of upper ureteral calculus treated with retroperitoneal laparoscopic ureterolithotomy from March 2013 to September 2015 were reviewed and evaluated.Results: Fifty-one cases were subjected to retroperitoneal laparoscopic ureterolithotomy successfully.Operative time was 78 to 304 min (mean,168.4±53.4 min).In one case,the stone migrated back to the renal pelvis and treated by extracorporeal shock wave lithotripsy (ESWL) postoperatively.One case suffered postoperative bleeding and recovered well after conservative treatment with transfusion.Fifty-one patients were followed up from 1 to 30 months.Therewere no strictures of the ureterotomy or recurrence of calculus.In all 51 cases,the pre-operativehydronephrosis were improved.Conclusions: Retroperitoneal laparoscopic ureterolithotomy in patients with upper ureteral calculus is safe,with less complications and satisfactory efficacy.Long follow-up is recommended.
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