后腹腔镜治疗肾盂单发较大结石剖析.docVIP

后腹腔镜治疗肾盂单发较大结石剖析 　　【摘要】目的探讨后腹腔镜肾盂切开取石术治疗肾盂单发较大结石的临床效果。方法肾盂单发较大结石患者51例, 均为肾外型肾盂, 采用后腹腔镜肾盂切开取石术, 分析手术各相关指标及并发症的发生情况。结果51例均一期手术成功, 无中转开放手术病例, 平均手术时间为(139.24±34.21 )min, 平均出血量为(56.43±13.17 )ml, 无输血病例, 结石清除率为100%, 术后发热率为3.92%, 术后平均住院日为(4.87±0.71)d, 术后肾功能较术前差异无统计学意义(P0.05)。结论对于良好选择的病例, 后腹腔镜肾盂切开取石术具有出血少、结石清除率高、术后并发症少等优势, 可作为肾盂单发较大结石的可选术式。 　　【关键词】肾盂结石；腹腔镜；肾盂切开取石术 　　 　　Laparoscopic retroperitoneal pyelolithotomy in the treatment of solitary large renal pelvic stone LIU Jie, DING De-gang, LIU Jian-jun. Department of Urology, Henan Provincial People’s Hospital, Zhengzhou 450003, China 　　【Abstract】Objective To investigate the clinical effect of laparoscopic retroperitoneal pyelolithotomy (LRP) in the management of solitary large renal pelvic stones. Methods Setected 51 patients with solitary large renal pelvic stones and treated by LRP. We analyzed the occurrence of the relevant indicators and surgical complications. Results All of the 51 patients were down by LRP once successfully, and none of them conversion to open surgery. Without blood transfusion, the mean operative time was (139.24±34.21)min, mean estimated blood loss was (56.43±13.17)ml, mean postoperative hospital stay was (4.87±0.71)d , rate of postoperative fever was 3.92%, and stone-free rate was 100%. Compared with before surgery no significant difference was found in renal function. Conclusion With the advantage of less bleeding, high stone-free rate, less postoperative complications and lower postoperative hospital stay, LRP is another feasible surgical technique for well-selected patients with large renal pelvic stones. 　　【Key words】Renal pelvic stone; Laparoscope; Pyelolithotomy 　　腹腔镜技术已涵盖泌尿外科的各个领域, 并日益取代传统开放手术在泌尿外科的治疗地位。后腹腔镜肾盂切开取石术(laparoscopic retroperitoneal pyelolithotomy, LRP)因其操作的复杂性及较长的学习曲线, 在临床上运用较少。然而, 对于一些良好选择的特殊病例, 后腹腔镜肾盂切开取石术仍有其独特优势［1］。本文回顾本院临床病例资料, 探讨该术式在肾盂单发较大结石中的治疗效果。 　　1资料与方法 　　1. 1一般资料回顾分析本院2006年3月~2013年9月收治的单侧肾盂单发较大结石(直径≥2.5 cm, 且表面积≥5 cm2)患者51例, 其中男41例, 女10例, 平均年龄(39.28±6.47)(27~55)