CAJ | 학술논문

目的：探讨复杂性输尿管上段结石的最佳治疗方法。方法对68例复杂性输尿管上段结石患者行三种微创技术联合治疗。结果33例患者行输尿管镜或联合经皮肾镜碎石取石术（MPCNL）和后腹腔镜下输尿管切开取石术（RLU）治疗后，术中取尽结石率为90．9％（30／33）。11例患者行 MPCNL 或联合经尿道输尿管镜碎石取石术（URL）和 RLU 治疗后，术中取尽结石率为100％。24例行腹腔镜切开取石术（RLU），术中取尽结石率为100％。手术均获成功，无严重并发症发生。结论对于复杂性输尿管上段结石的微创治疗，应根据临床情况制定多种个性化治疗方案。
목적：탐토복잡성수뇨관상단결석적최가치료방법。방법대68례복잡성수뇨관상단결석환자행삼충미창기술연합치료。결과33례환자행수뇨관경혹연합경피신경쇄석취석술（MPCNL）화후복강경하수뇨관절개취석술（RLU）치료후，술중취진결석솔위90．9％（30／33）。11례환자행 MPCNL 혹연합경뇨도수뇨관경쇄석취석술（URL）화 RLU 치료후，술중취진결석솔위100％。24례행복강경절개취석술（RLU），술중취진결석솔위100％。수술균획성공，무엄중병발증발생。결론대우복잡성수뇨관상단결석적미창치료，응근거림상정황제정다충개성화치료방안。
Objective To investigate the best therapy of complicated upper ureteral calculi. Methods A total of 68 patients with complicated upper ureteral calculi underwent combined three mini-mally invasive therapies.Results In the 33 cases selected for ureteroscopy or combined minimally inva-sive percutaneous nephrolithotomy(MPCNL)and retroperitoneal laparoscopic ureterolithotomy(RLU),the stone-free rate was 90.9%(30 /33).In the 11 cases selected for MPCNL or combined ureteroscopic litho-tripsy(URL)and RLU,the stone-free rate was 100%.In the 24 cases selected for RLU,the stone-free rate was 100%.All the patients had successful operations without serious complications.Conclusion In the treatment of complicated upper ureteral calculi,multiple individual therapies should be considered accord-ing to the clinical condition.