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目的探讨后腹腔镜下肾盂输尿管上段切开取石术的临床疗效。方法2006年1月至2009年3月对20例肾盂输尿管上段结石患者,在腹腔镜下经腹膜后行肾盂输尿管切开取石术,其中13例手术前行ESWL治疗无效,7例为初次手术治疗。结石直径12~40 mm。结果1例因结石退至肾盂后改为开放手术,其余19例成功。手术时间70~280 min,平均90 min。术后全部获得随访,随访5~38个月,平均24个月,无并发症发生。结论后腹腔镜下肾盂输尿管上段切开取石术,具有安全、创伤小、术后恢复快等优点,可部分代替传统开放手术,对于较大的肾盂输尿管上段结石可作为首选的治疗方法。
Objective To investigate the clinical effect of retroperitoneoscopic laparoscopic ureteropelvic lithotomy. Methods From January 2006 to March 2009, 20 patients with ureteropelvic upper calculus underwent laparoscopic retroperitoneal ureterolithotomy. Of the 13 patients, ESWL was ineffective before operation and 7 patients were treated by first operation . Stones diameter 12 ~ 40 mm. Results of 1 case due to stones returned to the renal pelvis after the open surgery, and the remaining 19 cases were successful. The operation time was 70-280 min with an average of 90 min. All patients were followed up for 5 to 38 months with an average of 24 months without complications. Conclusions Retroperitoneoscopic ureteropelvic ureterolithotomy with lithotomy has the advantages of safety, less trauma and faster postoperative recovery, which may partially replace the traditional open surgery. For the larger ureteropelvic upper calculus may be the preferred treatment.