CAJ | 학술논문

目的：探讨后腹腔镜输尿管切开取石术（RL U ）治疗复杂性输尿管上段结石的疗效和手术技巧。方法回顾性分析2009年3月至2013年8月术前确诊为复杂性输尿管上段结石并行RL U治疗的33例患者的临床资料，其中男21例，女12例，平均年龄43岁，结石停留时间均大于8周。结果33例手术均获得成功，手术时间60～150 min ，平均90．6 min ，术中出血量约22～52 mL ，平均32 mL。15例术中发现合并输尿管息肉，同时进行处理。无严重并发症发生。术后3个月复查B超示患者肾积水消失或较术前明显减轻。所有患者均获得随访，随访3～27个月，无结石复发和输尿管狭窄等并发症发生。结论 RL U手术安全有效，可以代替传统开放手术，成为复杂性输尿管上段结石或经其他微创治疗失败患者的首选治疗方法。
목적：탐토후복강경수뇨관절개취석술（RL U ）치료복잡성수뇨관상단결석적료효화수술기교。방법회고성분석2009년3월지2013년8월술전학진위복잡성수뇨관상단결석병행RL U치료적33례환자적림상자료，기중남21례，녀12례，평균년령43세，결석정류시간균대우8주。결과33례수술균획득성공，수술시간60～150 min ，평균90．6 min ，술중출혈량약22～52 mL ，평균32 mL。15례술중발현합병수뇨관식육，동시진행처리。무엄중병발증발생。술후3개월복사B초시환자신적수소실혹교술전명현감경。소유환자균획득수방，수방3～27개월，무결석복발화수뇨관협착등병발증발생。결론 RL U수술안전유효，가이대체전통개방수술，성위복잡성수뇨관상단결석혹경기타미창치료실패환자적수선치료방법。
Objective To evaluate the efficacy and surgical techniques of retroperitoneal laparoscopic uret-erolithotomy(RLU) in the trectment of complex upper ureteral calculi .Methods The clinical data of 33 cases(21 males and 12 females) of complex upper ureteral calculi patients who underwent RLU ,from March 2009 to August 2013 ,were retrospectively analyzed .Results All the 33 cases underwent RLU successfully .Operative time ranged from 60 to 150 min(mean ,90 .6 min) .The average volume of surgical blood loss was 32 mL ,ranged from 22 to 52 mL .During the operations ,we dealed with 15 cases of ureteral calculi complicated by ureteric polyps simultaneously . No serious complications were encountered .B ultrasound after 3 months of operation showed the hydronephrosis dis-appeared or observably reduced compared with the preoperative status .During the period followed 3-27 months ,ure-teral stricture or recurrent calculus had not been found .Conclusion RLU is safe ,effective and minimally invasive procedure .It may be considered as the first-choice treatment for patients with complex upper ureteral stones or the other experienced unsuccessful minimally invasive treatments .It can replace the conventional open surgery .