CAJ | 학술논문

目的：探讨后腹腔镜输尿管切开取石术（RLU ）的方法及临床应用价值。方法回顾性分析采用RLU治疗18例19侧输尿管上段结石患者的临床资料，结石直径10～22 mm，平均13．6 mm，其中16例患者病程大于3个月，10例患者术前行体外冲击波碎石术（ESWL）失败。镜下放置6F双J管并缝合输尿管切口。结果18例19侧手术有1侧中转开放手术，其余18侧均获成功；手术时间65～150 min，平均82 min；术中出血平均20 mL；腹膜后引流管术后2～5天拔除，双J管术后3～4周拔除；无尿漏等并发症发生，术后住院时间4～9 d。随访3～35个月，患侧肾积水好转，无结石复发、输尿管狭窄等并发症出现。结论 RLU是治疗输尿管上段结石安全有效的微创方法。
목적：탐토후복강경수뇨관절개취석술（RLU ）적방법급림상응용개치。방법회고성분석채용RLU치료18례19측수뇨관상단결석환자적림상자료，결석직경10～22 mm，평균13．6 mm，기중16례환자병정대우3개월，10례환자술전행체외충격파쇄석술（ESWL）실패。경하방치6F쌍J관병봉합수뇨관절구。결과18례19측수술유1측중전개방수술，기여18측균획성공；수술시간65～150 min，평균82 min；술중출혈평균20 mL；복막후인류관술후2～5천발제，쌍J관술후3～4주발제；무뇨루등병발증발생，술후주원시간4～9 d。수방3～35개월，환측신적수호전，무결석복발、수뇨관협착등병발증출현。결론 RLU시치료수뇨관상단결석안전유효적미창방법。
Objective To evaluate the treatment of upper ureteral calculi by retroperitoneal laparoscopic ureterolithotomy(RLU). Methods The clinical data of 18 cases(19 ureters)underwent RLU were retrospectively analyzed,the diameters of the calculi varied from 10 to 22 mm,the average was 13.6mm,the courses of the disease of 16 patients were more than 3 months,RLU was carried out in 10 patients af-ter unsuccessful ESWL.All the cuts of ureters were well sutured and D-J tube of 6F were well placed.Results Of all the cases,18 ureters underwent RLU successfully,only 1 ureter converted to open surgery;the time consuming of the operation ranged from 65 to 150 minutes,the average was 82 minutes;the average of the amount of blood loss were 20ml;the time of retaining of the draining tube after operation ranged from 2 to 5 days.D-J tubes were removed 3 to 4 weeks after operation.without complications such as leakage of urine,etc.The postoperative hospital stay was 4 to 9 days.With 3-35 months follow-up,the hydronephrosis relieved,there was no recurrent calculi or ureteric stricture had been found.Conclusions RLU is a safe,reliable and minimally invasive way to treat upper ureteral calculi.