关键词: 腹腔镜输尿管切开取石术, 输尿管上段结石, 输尿管镜碎石取石术, 治疗

Abstract: Objective To evaluate the clinical value of laparoscopic ureterolithotomy for upper ureteral calculi. Methods All the surgical-treated upper ureteral calculi cases from January 2013 to December 2018 in Peking University Shenzhen hospital were reviewed. The 121 laparoscopic ureterolithotomy （LUL） cases were divided into the study group， while 152 ureteroscopic lithotripsy （USL） cases were in the control group. Then we compared the stone-free rate， surgical complications and some other clinical data between the two groups. Results The LUL group had a higher stone-free rate （97.5% vs 84.2%， P<0.001） and a lower surgical complication rate （8.3% vs 18.4%， P=0.012） than the USL group. However， the LUL cases had more intraoperative bleeding （P<0.001）， longer operation time （P<0.001） and longer postoperative hospitalization time （P<0.001）. Conclusion For the surgical treatment of upper ureteral calculi， laparoscopic ureterolithotomy provides higher stone-free rate and leads to less surgical complications， but has more intraoperative bleeding， longer operation time and longer postoperative hospitalization time， and demands higher technical level. A surgeon should choose the appropriate way of operation according to his technical condition， feature of the case and patient′s requests.

Key words: laparoscopic ureterolithotomy, upper ureteral calculi, treatment, ureteroscopic lithotripsy