腹腔镜下中上段输尿管切开取石术.pdfVIP

616 JournalofClinicalUrology，AugZOO7，Vol22，Nos 腹腔镜下中上段输尿管切开取石术 徐红方’ 童雪芳’ 陆红全’ 张大宏’ 〔摘要〕 目的:探讨腹腔镜下中上段输尿管切开取石术的疗效和临床意义。方法:2。。5年9月一20o6年12 月收治输尿管中上段结石18例，采用经腹腔途径腹腔镜下施行输尿管中上段切开取石术手术，取石后直接于镜 下置人双J管，缝合输尿管切口及肾周筋膜。结果:18例手术均获成功，无一例中转开放手术，手术时间30~93 min，平均44min，失血20一50ml，均未输血，术后次日可下床活动，1一2天均肛门排气，1~3天拔除腹腔引流管， 5一7天拔导尿管，肉眼血尿3一5天，术后住院时间5~7天，3一4周后膀胧镜下拔除双J管，随访3一15个月，B 超显示肾积水明显好转或消失。结论:腹腔镜下中上段输尿管切开取石术疗效好，创伤小、痛苦少、恢复快，更适 用于不具备输尿管肾镜设备和技术的基层医院。 关〔健词〕输尿管结石;腹腔镜;输尿管切开取石术 【中图分类号」R693.4 【文献标识码〕A [文章编号] 1001一1420(2007)08一0616一02 MiddleanduPPersegmentalureterolithotomywithlaParoscoPy XUHongfang’TONGXuej议ng’LUHongguan‘ZHANGDahong’ (D‘epartmentofUrology，ChineseHospitalofTongluCounty，Tonglu，Zhejiang，311500， China) Abstracto场ective:ThePurposeistodiscussthecurativeeffectandclinicmeaningofthelaparoscopyset whenitisusedformiddleanduppersegmentalureterolithotomy.Methods:18patientswhohasupperandmiddle segmentalconcretionhavebeenacceptedduringSept.ZOostodec.2006.Therearel4maieand4female.Thepa- tients’agescopeisZI一63andadvantageageis42yearsold.Thereare1Opatientshavingthestoneintheleft kidney，7intherightandlinbothsides.TheuPPerandmiddlesegmentalureterolithotomywereoperatedbylaP- aroscopysetthroughtheabdominalcavity.Inserttwo“J”tubeswhenthestonewastakenout，thensewupthe cutofureterandperirenaIaponeurosis.Results:Thel8operationcasesareallsuccessfulandnooneneedopenop- eration.Thetimefortheoperationis3oto93mins，theadvantagetimeis44mins.Thecapacityofbloodlossis 20mlto50mland明on龟needbloodtransfusion.Patientscanwalknextday.TheanuscanexhaustinltoZdays andtheceliacdrainag亡tubecanbepulledoutinlto3days.Theuretertubecanbepulledoutin5to7days.The phenomenonofmacroscopichematuriawillbelastfor3to5days.Daysinhospita1isusual5to7daysafteropera- tion.Andtwo