CAJ | 학술논문

目的：比较后腹腔镜下输尿管切开取石术（RLU）与经输尿管硬镜钬激光碎石术（URSL）治疗输尿管上段结石的疗效。方法：回顾分析同期26例后腹腔镜下取石和32例经输尿管镜钬激光碎石治疗输尿管上段结石患者的临床资料。结果：RLU组26例患者手术成功，2例因术中解剖定位不清，1例结石上移至肾盂改为开放手术，患者结石均一次性取尽。 URSL组32例患者无1例中转开放手术，3例患者术后不同程度结石上移、残留，结合术后体外震波碎石将结石排出。结论：RLU和URSL治疗输尿管上段结石均安全有效，均能同时解除输尿管局部狭窄或息肉，URSL具有创伤小、恢复快的优点，但结石残留率较高；RLU不但创伤小，结石清除率更高，还能作为URSL治疗失败的补救措施。
목적：비교후복강경하수뇨관절개취석술（RLU）여경수뇨관경경화격광쇄석술（URSL）치료수뇨관상단결석적료효。방법：회고분석동기26례후복강경하취석화32례경수뇨관경화격광쇄석치료수뇨관상단결석환자적림상자료。결과：RLU조26례환자수술성공，2례인술중해부정위불청，1례결석상이지신우개위개방수술，환자결석균일차성취진。 URSL조32례환자무1례중전개방수술，3례환자술후불동정도결석상이、잔류，결합술후체외진파쇄석장결석배출。결론：RLU화URSL치료수뇨관상단결석균안전유효，균능동시해제수뇨관국부협착혹식육，URSL구유창상소、회복쾌적우점，단결석잔류솔교고；RLU불단창상소，결석청제솔경고，환능작위URSL치료실패적보구조시。
Objective:Compare the curative effects of RLU And URSL in treating upper ureteral calculi.Method:retrospective analysis of clinical data.26 cases of RLU and 32 cases of URSL.Result:26 cases in RLU group proved successful in surgery. 3 cases changed into open surgery with all stone removed once, 2 due to unclear anatomy local-ity, and 1 because of stone moving to pelvis. 32 cases in URSL had no cases changing into open surgery. 3 cases were found stone upward movement or residual stone but were removed after extracorporeal shock-wave lithotomy.Conclu-sion:RLU and URSL are safe and effective in treating upper ureteral calculi, which can remove ureteral stenosis or polyp. URSL has the advantages of little trauma and quick recovery, but high residual stone rate.RLU has little trau-ma, and higher stone clearance rate, which can serve as a remedial measure if URSL proves unsuccessful.