[1]钟羽翔,麦源,黄剑华,等.两种路径腹腔镜输尿管切开取石术的比较[J].中国微创外科杂志,2017,17(08):707-709.
　Zhong Yuxiang,Mai Yuan,Huang Jianhua,et al.A Comparative Study of Laparoscopic Ureterolithotomy: Transperitoneal Approach Versus Retroperitoneal Approach[J].Chinese Journal of Minimally Invasive Surgery,2017,17(08):707-709.
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两种路径腹腔镜输尿管切开取石术的比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年08期
页码:
707-709
栏目:
临床研究
出版日期:
2017-08-20

文章信息/Info

Title:
A Comparative Study of Laparoscopic Ureterolithotomy: Transperitoneal Approach Versus Retroperitoneal Approach
作者:
钟羽翔; 麦源; 黄剑华; 韦巍; 徐战平*
广东省佛山市中医院泌尿外科，佛山528000
Author(s):
Zhong Yuxiang;  Mai Yuan;  Huang Jianhua;  et al.
Department of Urology, Foshan Hospital of TCM, Foshan 528000, China
关键词:
输尿管结石; 腹腔镜; 后腹腔镜; 输尿管切开取石术
Keywords:
Ureteral calculi; Laparoscopy; Retroperitoneal laparoscopy; Ureterolithotomy
文献标志码:
A
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（P>0.05）。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:
ObjectiveTo compare the outcomes of laparoscopic ureterolithotomy (LU) and retroperitoneal laparoscopic ureterolithotomy (RLU) as a primary treatment for a large impacted stone in the proximal ureter. MethodsA total of 43 patients with a solitary, large (>1.5 cm), and impacted stone in the proximal ureter were selected and divided into two groups. The first group included 22 patients who were treated by LU, and the second group included 25 patients who were treated by RLU. Patient demographics and stone characteristics as well as the operative and postoperative data of both groups were compared and statistically analyzed. ResultsThe operation was successfully completed in all the 22 cases in the LU group, and in 21 cases in the RLU group, with 1 case of stone moving to the pelvis receiving retroperitoneal laparoscopic pyelolithotomy and 3 cases of conversion to open surgery due to severe adhesion of peripheral ureteral inflammation. The mean operative time was significantly shorter in the LU group than in the RLU group ［(74.5±8.1) min vs. (87.3±9.9) min, t=-4.636, P=0.000］. The bowel function recovery time was significantly longer in the LU group than in the RLU group ［(2.4±1.2) d vs. (1.6±0.9) d, t=2.394, P=0.021］. There was no statistically significant difference between the two groups regarding the bleeding volume, postoperative hospital stay, drainage time, and complication rate (P>0.05).ConclusionsBoth approaches of laparoscopic ureterolithotomy are effective in treating large impacted stones in the proximal ureter. LU has significantly shorter operative time and is ideal for lower ureteral calculus.

参考文献/References:

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备注/Memo

备注/Memo:
*通讯作者，Email：xuzhanping2004@163.com
更新日期/Last Update: 2017-11-22