[摘要] 目的 探讨后腹腔镜下输尿管上段切开取石术的技术要点及临床价值。方法 从2008年5月~2010年8月采用腹腔镜下腹膜后输尿管上段切开取石术22 例,其中6 例于术前行ESWL 治疗失败;其余16 为初次手术治疗。结石直径10～20 mm ,平均14 mm。多数患者病程大于1个月,最长为半年。22 例均缝合输尿管切口并放置双J 管。结果 22 例手术均获成功;手术时间60～180 min ,平均80.2 min ;除1 例发生术后双J管位置欠佳,其余术后3～5 天拔除腹膜后引流管,术后住院时间4～7 天。随访1～18 个月,无严重并发症出现。结论 后腹腔镜下输尿管上段切开取石术是安全有效的治疗输尿管上段结石的微创方法,适用于结石较大,病程较长或其他治疗方法失败者,可部分代替传统开放手术。

    关键词：后腹腔镜 输尿管上段结石

    Retroperitoneoscopic upper uretero lithotomy ( The experience of 22 cases)

    Abstract Objective : To investigate the technical detail of retroperitoneoscopic upper ureterolithotomy and evaluate it s clinical effect . Methods : From May 2008 to August2010 , retroperitoneoscopic upper ureterolithotomy was carried out in 22 patient s , 6 of whom were treated using this method as a salvage procedure after unsuccessful ESWL. The stone size ranged f rom 10～25 mm(mean 14 mm) with the incarceration time from 1 months to 6 months.Results :Retroperitoneoscopic upper ureterolithotomy was successful in 22 patients ......