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目的探讨输尿管支架逆行置入在后腹腔镜输尿管切开取石治疗输尿管中段结石的临床疗效和安全性。方法回顾分析本科行后腹腔镜治疗输尿管结石6例,结石均位于L3~5平面,6例患者结石直径1.5~2.0 cm,平均直径1.8 cm。术前行体外冲击波碎石术(ESWL)均失败。取石成功后,逆行置入输尿管支架。结果 6例患者均手术成功,手术时间90~150 min,平均时间115 min;术中失血量10~25 ml,平均失血量15 ml;术后未出现漏尿,于术后3~5 d拔出腹膜后引流管。术后平均住院5.8 d。结论后腹腔镜输尿管切开取石术中的应用可作为ESWL失败患者的补救措施,结石取净率高、损伤较小、安全可靠,同时术中逆行置入输尿管支架可以明显缩短手术时间,值得临床推广应用。
Objective To investigate the clinical efficacy and safety of ureteral stent retrograde placement in retroperitoneal laparoscopic ureteral calculi for the treatment of middle ureteral calculi. Methods Retrospective analysis of the undergraduate laparoscopic treatment of ureteral calculi in 6 cases, stones are located in the L3 ~ 5 plane, 6 patients with stone diameter of 1.5 ~ 2.0 cm, with an average diameter of 1.8 cm. Preoperative ESWL failed. After successful stone removal, retrograde ureteral stent placement. Results All the 6 patients were operated successfully. The operation time was 90-150 min and the average time was 115 min. The intraoperative blood loss was 10-25 ml and the mean blood loss was 15 ml. No leakage of urine was found after operation, A retroperitoneal drainage tube. The average postoperative hospital stay was 5.8 days. Conclusions The application of retroperitoneal laparoscopic ureterolithotomy can be used as a remedy for patients with failed ESWL. High rates of stone removal, less damage and safety are the key factors in the treatment of ESWL. Concurrent intraoperative ureteral stenting can significantly shorten the operation time and is worth clinical treatment Promote the application.