两种路径腹腔镜输尿管切开取石术的比较

发布时间：2018-04-23 11:01

本文选题：输尿管结石 + 腹腔镜　；参考：《中国微创外科杂志》2017年08期

【摘要】：目的比较两种路径腹腔镜输尿管切开取石术治疗嵌顿性输尿管上段结石的临床效果。方法回顾性分析2015年6月~2016年10月47例输尿管上段单发嵌顿性结石资料,结石长径1.5 cm。22例行腹腔镜输尿管切开取石术(laparoscopic ureterolithotomy,LU),25例后腹腔镜输尿管切开取石术(retroperitoneal laparoscopic ureterolithotomy,RLU),比较2组手术时间、术后肠道功能恢复时间、引流管拔除时间、术后并发症、住院时间。结果 LU组22例手术均获成功;RLU组手术成功21例,1例术中结石迁移到肾盂,后腹腔镜下肾盂切开取出,3例输尿管周围炎导致严重粘连无法找到输尿管而中转开腹手术。与RLU组相比,LU组手术时间短[(74.5±8.1)min vs.(87.3±9.9)min,t=-4.636,P=0.000],但术后排气晚[(2.4±1.2)d vs.(1.6±0.9)d,t=2.394,P=0.021]。2组出血量、住院时间、拔除引流管时间、并发症发生率无统计学差异(P0.05)。结论 LU和RLU都是安全有效的,LU相对RLU手术时间更短,对于位置偏低的输尿管上段结石更有优势,二者均是理想的手术方式。
[Abstract]:Objective to compare the clinical effects of laparoscopic ureterotomy and lithotomy in the treatment of incarcerated upper ureteral calculi. Methods from June 2015 to October 2016, 47 cases of upper ureteral solitary incarcerated calculi were retrospectively analyzed. Laparoscopic ureterolithotomy (LUU) was performed in 25 patients with laparoscopic ureterolithotomy (LUU). The operative time, postoperative intestinal function recovery time, drainage tube extraction time, postoperative complications and hospitalization time were compared between the two groups. Results in LU group, 21 cases of RLU group were successfully operated and 1 case of stones migrated to renal pelvis. 3 cases of ureteral periureteritis were removed by retroperitoneal laparoscopic pyelolithotomy, and the severe adhesion of ureter could not be found and the operation was converted to open operation. Compared with the RLU group, the operation time of LU group was shorter [74.5 卤8.1)min vs.(87.3 卤9.9 vs.(87.3 卤4.636 RLU], but there was no significant difference in the incidence of complications between the two groups (2.4 卤1.2 vs.(1.6 卤0.994 vs.(1.6 卤2.394P0. 021). 2. 2. 2. The time of hospitalization, the time of removing the drainage tube, and the incidence of complications were not significantly different (P 0. 05). Conclusion both LU and RLU are safe and effective, and LU has shorter operation time than RLU, and is more advantageous for upper ureteral calculi with lower location. Both of them are ideal surgical methods.
【作者单位】：广东省佛山市中医院泌尿外科;
【分类号】：R699.4

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