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目的:初步探讨自制套管单孔后腹腔镜输尿管切开取石术的可行性和安全性。方法:分析2011年6月~2013年12月采用自制套管进行单孔后腹腔镜输尿管切开取石术23例患者的临床资料和随访结果。结果:23例手术均顺利完成,无中转开放及转为标准腹腔镜手术。结石的平均直径(17.0±2.4)mm,手术时间(112.8±21.6)min,出血量(34.3±11.3)ml,术中无并发症发生,术后第1天疼痛评分(0.5±2.4)分,未用镇痛剂,术后平均住院时间(4.4±0.6)天,2例术后出现尿漏,术后第3天停止,无残留结石及输尿管狭窄患者。结论:单孔腹腔镜下输尿管切开取石术是一种安全、有效的手术方法。明确诊断,熟悉后腹膜解剖结构,熟练掌握腹腔镜手术操作技巧,配合自制单孔通道,都是成功完成手术治疗的关键。
Objective: To investigate the feasibility and safety of laparoscopic ureterolithotomy with self-made single-hole cannula. Methods: The clinical data and follow-up results of 23 patients with laparoscopic ureterolithotomy using a single hole after self-made cannulation from June 2011 to December 2013 were analyzed. Results: All the 23 cases were successfully completed. There were no transit and standard laparoscopic surgery. The average diameter of stones was (17.0 ± 2.4) mm, the operation time was 112.8 ± 21.6 min, and the amount of bleeding was 34.3 ± 11.3 ml. There was no intraoperative complications and the pain score was 0.5 ± 2.4 on the first postoperative day. No analgesics, the average postoperative hospital stay (4.4 ± 0.6) days, 2 cases of postoperative urine leakage, stopped after 3 days, no residual stones and ureteral strictures. Conclusion: Single-hole laparoscopic ureterolithotomy is a safe and effective surgical method. A clear diagnosis, familiar with the retroperitoneal anatomy, proficiency in laparoscopic surgical techniques, with a single hole channel, are the key to the successful completion of surgical treatment.