CAJ | 학술논문

目的：比较输尿管镜钬激光碎石术（ URS）和后腹腔镜输尿管切开取石术（ RPLU）治疗输尿管上段结石的疗效。方法回顾性分析2011年5月-2012年5月上段输尿管结石70例的临床资料，其中行URS 38例，行RPLU 32例，对比两组患者手术成功率、手术时间、术中出血量、术后住院时间和术后并发症的差异。结果 URS组38例结石一次性取净率（直径无＞4 mm结石残留）为86．8％（33/38），RPLU组32例结石一次性取净率为100．0％。 URS组手术时间（85．63±14.01）min，术中出血量（11．18±7．11）mL，术后住院时间（3．95±1．51） d，术后并发症5例，RPLU组分别为（79．94±18．59） min，（20.94±10．96）mL，（4．53±1．24）d和0例。 RPLU组在手术成功率上显著高于URS组，在术后并发症上也显著低于URS组（均P＜0．05）。而在术中出血量上URS组则显著少于RPLU组（P＜0．05）。在手术时间和术后住院天数上，两组比较差异无统计学意义（ P＞0．05）。结论 URS与RPLU比较，RPLU治疗上段输尿管结石手术成功率高，术后并发症少，而URS失血量少。
목적：비교수뇨관경화격광쇄석술（ URS）화후복강경수뇨관절개취석술（ RPLU）치료수뇨관상단결석적료효。방법회고성분석2011년5월-2012년5월상단수뇨관결석70례적림상자료，기중행URS 38례，행RPLU 32례，대비량조환자수술성공솔、수술시간、술중출혈량、술후주원시간화술후병발증적차이。결과 URS조38례결석일차성취정솔（직경무＞4 mm결석잔류）위86．8％（33/38），RPLU조32례결석일차성취정솔위100．0％。 URS조수술시간（85．63±14.01）min，술중출혈량（11．18±7．11）mL，술후주원시간（3．95±1．51） d，술후병발증5례，RPLU조분별위（79．94±18．59） min，（20.94±10．96）mL，（4．53±1．24）d화0례。 RPLU조재수술성공솔상현저고우URS조，재술후병발증상야현저저우URS조（균P＜0．05）。이재술중출혈량상URS조칙현저소우RPLU조（P＜0．05）。재수술시간화술후주원천수상，량조비교차이무통계학의의（ P＞0．05）。결론 URS여RPLU비교，RPLU치료상단수뇨관결석수술성공솔고，술후병발증소，이URS실혈량소。
Objective To compare the clinical effect of ureteroscopic holmium laser lithotripsy and retro -peritoneal laparo-scopic ureterolithotomy on treatment of upper ureteral calculus .Methods The data of 70 cases of hospitalized patients with upper ure-teral calculus between May 2011 and May 2012 were retrospectively studied .They were divided into ureteroscopy ( URS) with holmium laser lithotripsy group (38 cases) and retro-peritoneal laparoscopic ureterolithotomy (RPLU) group (32 cases).The data of curative rate,operation time,blood loss,postoperation hospitalization time and complications were compared respectively .Results The curative rate (no calculus>4 mm left) of URS group were 86.8% (33/38),while the curative rate of RPLU group were 100.0%.In URS group,the operation time was (85.63 ±14.01) min,the blood loss was (11.18 ±7.11)mL,the postoperation hospitalization time was (3.95 ±1.51) d and the complication was 5 cases.While the data of these index in RPLU group were (79.94 ±18.59) min,(20.94 ±10.96) mL,(4.53 ±1.24) d and 0 case respectively.There were statistically significant difference in curative rate ,complication and blood loss between RPLU group and URS group (P<0.05).There was no statistically significant differences in operation time and postoperation hospitalization time between the two groups (P>0.05).Conclusion Comparing with URS,RPLU has advantage on higher curative rate and lower complications in the treatment of upper ureteral calculus .While the blood lose of URS is less .