CAJ | 학술논문

目的：探讨经腹腔入路腹腔镜输尿管切开取石术治疗嵌顿性输尿管上段结石的方法与临床价值.方法：2013年1月~2014年2月,经腹腔入路腹腔镜切开取石术治疗第三腰椎(L3)以下嵌顿性输尿管上段结石18例,其中7例术前行体外冲击波碎石失败.结石长径1.3~3.0 c m,平均2.1 c m.结果：手术均获成功,无中转手术病例.手术时间45~130 mi n ,平均75 mi n .术中估计失血量20~55 ml ,平均35 ml .术后1例出现漏尿,引流2周后消失.无肠梗阻等并发症.术后随访1~11个月,平均5个月,无结石复发和输尿管狭窄病例.结论：对于 L3以下嵌顿性输尿管上段结石,经腹腔入路腹腔镜输尿管切开取石术具有空间大、解剖标志清晰、避免反角度操作等优势,值得临床选用.
목적：탐토경복강입로복강경수뇨관절개취석술치료감돈성수뇨관상단결석적방법여림상개치.방법：2013년1월~2014년2월,경복강입로복강경절개취석술치료제삼요추(L3)이하감돈성수뇨관상단결석18례,기중7례술전행체외충격파쇄석실패.결석장경1.3~3.0 c m,평균2.1 c m.결과：수술균획성공,무중전수술병례.수술시간45~130 mi n ,평균75 mi n .술중고계실혈량20~55 ml ,평균35 ml .술후1례출현루뇨,인류2주후소실.무장경조등병발증.술후수방1~11개월,평균5개월,무결석복발화수뇨관협착병례.결론：대우 L3이하감돈성수뇨관상단결석,경복강입로복강경수뇨관절개취석술구유공간대、해부표지청석、피면반각도조작등우세,치득림상선용.
To explore the method and clinical value of laparoscopic ureterolithoto my intreatment of impacted upper ureteral calculi below the third lumbar vertebravia transperitoneal approach .Methods :From January 2013 to February 2014 ,laparoscopic ureterolithoto my was carried out on 18 patients with impacted upper ureteral calculivia transperitoneal access .Of all patients ,7 had been treated with ES WL before .The mean stone size was 2.1cm (range 1.3 to 3.0 cm).Results :Laparoscopic ureterolithoto my was successfully performed on all cases without conversi on to open surgery .Mean operative time was 75 min (range 45 to 130 min ).Mean esti mated blood loss was 35mL (range 20 to 55mL ).Urine leakage occurred in one case and disappeared by drainage for 2 weeks .Mean fol-low- up period was 5 months (range 1 to 11 months ),and no ureteric stricture or recurrent calcul us were found .Con-clusions :Laparoscopic ureterolithoto my via transperitoneal approach deserves clinical applicati on in treat ment of im-pacted upper ureteral calculi for the advantages of spacious space ,clear anato mical land marks and relati vely simple manipulation .