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后腹腔镜输尿管切开取石术与输尿管镜碎石术治疗输尿管上段结石的效果比较。

Comparison of the effects of retroperitoneoscopic ureterolithotomy and ureteroscopic lithotripsy in the treatment of upper ureteral calculi.

机构信息

Department of Urology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.

Dalian Medical University, Dalian, China.

出版信息

Medicine (Baltimore). 2021 Sep 24;100(38):e27328. doi: 10.1097/MD.0000000000027328.

Abstract

This study compares the efficacy of retroperitoneoscopic ureterolithotomy (RPUL) and ureteroscopic lithotripsy (URL) in the treatment of upper ureteral calculi.The clinical data of 150 patients with upper ureteral calculi who underwent RPUL and 136 patients who underwent URL between January 2014 and October 2019 were retrospectively analyzed. The operation time, postoperative hospital stay, operation success rate, stone clearance rate, and surgical complications were evaluated between the two groups.For the RPUL and URL groups, respectively, the average operation time was 74.5 ± 24.6 minutes and 54.5 ± 13.2 minutes; the postoperative hospital stay was 5.8 ± 1.4 days and 3.2 ± 1.2 days; the operation success rate was 96.0% (144/150) and 85.3% (116/136); the incidence rate of complications was 3.5% (5/144) and 17.5% (18/103); and the stone clearance rate was 100% (144/144) and 88.8% (103/116), which were all statistically significant (P < .05).Both RPUL and URL had the advantages of low trauma and fast recovery rate for patients with upper ureteral calculi. However, patients who underwent RPUL showed higher success and fewer complication rate. RPUL might be a safe and effective laparoscopic method for the treatment of patients with upper ureteral calculi.

摘要

本研究比较了后腹腔镜输尿管切开取石术(RPUL)和输尿管镜碎石术(URL)治疗输尿管上段结石的疗效。回顾性分析了 2014 年 1 月至 2019 年 10 月期间 150 例接受 RPUL 和 136 例接受 URL 治疗的输尿管上段结石患者的临床资料。评估两组患者的手术时间、术后住院时间、手术成功率、结石清除率和手术并发症。RPUL 和 URL 组的平均手术时间分别为 74.5±24.6 分钟和 54.5±13.2 分钟;术后住院时间分别为 5.8±1.4 天和 3.2±1.2 天;手术成功率分别为 96.0%(144/150)和 85.3%(116/136);并发症发生率分别为 3.5%(5/144)和 17.5%(18/103);结石清除率分别为 100%(144/144)和 88.8%(103/116),差异均有统计学意义(P<0.05)。

RPUL 和 URL 治疗输尿管上段结石均具有创伤小、恢复快的优点。但 RPUL 组成功率较高,并发症发生率较低。RPUL 可能是治疗输尿管上段结石安全有效的腹腔镜方法。

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