【摘要】 目的探讨腹腔镜经肠系膜途径输尿管切开取石术治疗中上段输尿管结石临床应用价值。方法回顾地分析2016年1月至2019年3月腹腔镜下经肠系膜途径治疗的68例输尿管中上段结石患者临床资料。记录患者的性别、年龄、手术时间、术中出血量、术后肠道恢复时间,术后症状改善和B超复查结果。结果 67例手术取石顺利,有1例结石上行到肾盂而行体外冲击波碎石治疗。手术时间(41.2±4.7)min,术中出血量(5.3±1.6)mL,术后肠道恢复时间(9.5±2.1)h。68例患者随访1～36个月,全部患者肾输尿管积水明显好转,无结石复发和输尿管切开缝合处狭窄。结论对体形瘦、肠系膜脂肪少的中上段输尿管结石患者,腹腔镜经结肠系膜途径输尿管切开取石安全有效,可以减少创伤、缩短肠道恢复及手术时间。更多还原

【Abstract】 Objective To explore the application value of laparoscopic ureterolithotomy by transmesenteric approach in the treatment of middle and upper ureteral calculi.Methods Clinical data of 68 ureterolithiasis patients who underwent laparoscopic ureterolithotomy by transmesenteric approach during Jan.2016 and Mar.2019 were retrospectively analyzed,including patients’gender,age,operation time,intraoperative blood loss,postoperative intestinal recovery time,postoperative symptom improvement and B ultrasound results.Results All operations were successful,and 1 case converted to extracorporeal shock wave lithotripsy for calculi ascended to the renal pelvis.The operation time was(41.2±4.7)min,intraoperative blood loss was(5.3±1.6)mL,and postoperative intestinal recovery time was(9.5±2.1)h.During the follow-up of 1-36 months,hydronephrosis was significantly improved in all patients,and no recurrence of calculi or stenosis of ureter occurred.Conclusion Laparoscopic ureterolithotomy by transmesenteric approach is safe and effective in the treatment of middle and upper ureteral calculi in patients with thin body and little mesenteric fat.It can reduce trauma,shorten intestinal recovery and operation time.更多还原