Efficacy of retroperitoneal laparoscopic ureterolithotomy for the treatment of large proximal ureteric stones and its impact on renal function.
Efficacy of retroperitoneal laparoscopic ureterolithotomy for the treatment of large proximal ureteric stones and its impact on renal function.
复制标题
腹膜后腹腔镜输尿管碎石术治疗输尿管近端大结石的疗效及其对肾功能的影响。
DOI：
10.1186/2193-1801-2-600
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Kohri K
中科院分区：
文献类型：
--
作者：
Yasui T;Okada A;Hamamoto S;Taguchi K;Ando R;Mizuno K;Itoh Y;Tozawa K;Hayashi Y;Kohri K
本研究的目的是评价后腹腔镜输尿管切开取石术治疗输尿管近端大结石的疗效以及该治疗对术后肾功能的影响。回顾性分析了12例（男7例，女5例;平均年龄68.5 ± 8.9岁）肾盂输尿管连接部大结石（2例）和输尿管上段结石（10例）（25.3 ± 7.4 mm）行后腹腔镜输尿管切开取石术的资料。术前及术后3个月分别测定肾小球滤过率（eGFR）和99 mTc-巯基乙酰三甘氨酸（99 mTc-MAG 3）肾功能显像。平均手术时间为129.5 ± 21.4分钟，平均失血量为64.4 ± 78.2 mL。术后平均住院时间为6.4 ± 2.7天，平均支架植入时间为7.2 ± 1.7周。结石清除率达到100%，没有患者发生输尿管狭窄。99 mTc-MAG 3造影显示腹腔镜取石不影响肾功能，但改善输尿管阻塞。后腹腔镜输尿管切开取石术是一种安全有效的治疗方法，可以减少输尿管近端大结石患者的输尿管梗阻。
The purpose of this study was to evaluate the efficacy of retroperitoneal laparoscopic ureterolithotomy for the management of large proximal ureteric stones and the impact of this treatment on postoperative renal function. The data of 12 patients (7 men and 5 women; mean age, 68.5 ± 8.9 years) with large pyeloureteral junction (2 cases) and upper ureteral (10 cases) stones (25.3 ± 7.4 mm) that had undergone retroperitoneal laparoscopic ureterolithotomy were reviewed. Renal function was analyzed by the estimated glomerular filtration rate (eGFR) and renal scintigraphy using 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) before and 3 months after surgery. The mean operative time was 129.5 ± 21.4 minutes, with a mean blood loss of 64.4 ± 78.2 mL. The mean duration of hospital stay after surgery was 6.4 ± 2.7 days, and the mean duration of stenting was 7.2 ± 1.7 weeks. A stone clearance rate of 100% was achieved, and no patient developed ureteric stricture. 99mTc-MAG3 scintigraphy showed that laparoscopic removal of calculi did not affect renal function, but did improve ureteral occlusion. Retroperitoneal laparoscopic ureterolithotomy is a safe and effective treatment option for reducing ureteral obstruction in select patients with large proximal ureteric stones.