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腹腔镜下快速输尿管切开取石术技巧

Technique of transperitoneal laparoscopic ureterolithotomy:how to do it in a quicker way

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【作者】 张大宏余大敏丁国庆陈岳兵许力为李新德

【Author】 ZHANG Da-hong *,YU Da-min,DING Guo-qing,et al. *Department of Urology,Affiliated Shaoyifu Hospital,Medical College,Zhejiang University,Hangzhou 310016,China

【机构】 浙江大学医学院附属邵逸夫医院泌尿外科浙江大学医学院附属邵逸夫医院泌尿外科 310016杭州310016杭州

【摘要】 目的 介绍腹腔镜下快速输尿管切开取石术的技巧。 方法  2 0 0 2年 6月至 2 0 0 3年 1月应用三套管技术完成腹腔镜下输尿管切开取石术 4 2例 ,其中男 2 3例 ,女 19例 ;年龄 16~ 6 3岁 ,平均 4 2岁 ;左侧 2 6例 ,右侧 16例。 结果 手术均取得成功 ,手术时间 33~ 5 6min ,平均 4 3min ;失血2 0~ 5 0ml;术后住院时间 3~ 5d ,无 1例尿漏。随访 12~ 18个月 ,输尿管无狭窄 ,肾功能改善。 结论 合理的Trocar位置、准确的结石定位、锐性输尿管切开、良好的双J管引流和娴熟的缝合技术是腹腔镜下快速切开取石成功的关键。

【Abstract】 Objective To introduce a better and quicker technique of transperitoneal laparoscopic ureterolithotomy. Methods 42 cases of ureterolithiasis (23 males and 19 females;mean age of 42.4 years,range from 16 to 63 years) were included.Of them 26 cases had calculi on the left side and 16 cases,on the right side.All the cases underwent laparoscopy through 3-port technique. Results The operations were successful in all of 42 cases.The mean operative time was 43 min (range,33 to 56 min).Blood loss was 20 to 50 ml.The postoperative hospital stay was 3 to 5 days.None experienced urinary leakage.During the follow-up of 12~18 months no ureteral stricture was found.The renal functions were improved. Conclusions Our experience indicates that appropriate trocar location,exactly checking of calculi,good D-J tube drainage and skillful intra-abdomenal suturing are the keys to perform laparoscopic ureterolithotomy quickly.

【关键词】 输尿管结石腹腔镜术手术
【Key words】 UreterolithiasisLaparoscopyOperation
  • 【文献出处】 中华泌尿外科杂志 ,Chinese Journal of Urology , 编辑部邮箱 ,2004年05期
  • 【分类号】R699
  • 【被引频次】76
  • 【下载频次】211
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