Abstract: 【Abstract】〓Objective〓To investigate the efficacy of retroperitoneal laparoscopic ureterolithotomy for upper ureteral stone..Methods〓From July 2005 to December 2013,.51 consecutive patients with upper ureteral stone underwent retroperitoneal laparoscopic ureterolithotomy..Perioperative outcomes (operating time,estimated blood loss, complications) and stone free rate were analyzed retrospectively. Results〓Forty-nine cases of operation finished uneventfully, except for 2 cases converted to open surgery because of stone migration. The mean operating time for laparoscopic surgery was 75 minutes (55-125 minutes),.the mean estimated blood loss was 30 ml(10-50 ml), the stone free rate was 100%. Three patients experienced urine leakage,.which managed with conservative treatment..Two patients experienced ureteral stricture, which managed with endoincision and Double-J stent drainage. Conclusion〓Retroperitoneal laparoscopic ureterolithotomy is a minimally invasive treatment for upper ureteral stones with high stone free rate. It could be a salvage therapy for upper ureteral stones after failure to extracorporeal shock wave lithotripsy or ureteroscopic lithotripsy.

Key words: Laparoscopy, Ureterolithotomy, Retroperitoneal approach

摘要： 【摘要】〓目的〓探讨腹膜后入路腹腔镜输尿管切开取石治疗输尿管上段结石的疗效。方法〓回顾性分析2005年7月至2013年12月期间在我院接受腹膜后入路腹腔镜输尿管切开取石术的51例输尿管上段结石患者资料,观察手术时间、并发症、结石残留及恢复情况。结果〓49例(96.1%)患者(96.1%)顺利完成手术并取出结石,2例患者因结石上移入肾改行开放手术。腹腔镜手术病例的平均手术时间75分钟(55~125分钟);术中平均出血30 mL(10~50 mL),输尿管结石清除率达100%。3例(5.9%)患者术后出现漏尿,2例(3.9%)患者随访期间出现输尿管狭窄,需行内切开术并内置双J管引流。结论〓腹膜后入路腹腔镜输尿管切开取石术治疗输尿管上段结石具有创伤小、结石清除率高的特点,是治疗体外冲击波碎石和/或输尿管镜碎石治疗失败的输尿管上段结石的有效方法,适合在基层医院推广。

关键词: 腹腔镜, 输尿管切开取石术, 腹膜后入路