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  • 王可屹,王光春,黄建华,,等.三种不同微创术式治疗复杂输尿管上段结石的疗效及安全性分析[J].同济大学学报(医学版),2019,40(6):841-846.    [点击复制]
  • WANG Ke-yi, , , , , ,,WANG Guang-chun,HUANG Jian-hua,et al.Comparison of efficacy and safety of three different minimally invasive procedures for treatment of complicated upper ureteral calculi[J].同济大学学报(医学版),2019,40(6):841-846.   [点击复制]
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三种不同微创术式治疗复杂输尿管上段结石的疗效及安全性分析
王可屹,王光春,黄建华,,张海民,殷雷,侍恒,黄天润,彭波
0
(同济大学附属第十人民医院泌尿外科,上海 200072)
摘要:
目的 比较后腹腔镜输尿管切开取石术(retroperitoneal laparoscopic ureterolithotomy, RLU)、输尿管镜取石术(ureteroscopic lithotripsy, URL)及经皮肾镜取石术(percutaneous nephrolithotomy, PCNL)治疗复杂输尿管上段结石的临床疗效。方法 回顾性分析2006年1月至2017年12月同济大学附属第十人民医院收治符合纳入标准的585例复杂输尿管上段结石患者的手术疗效,其中RLU治疗206例,URL治疗201例,PCNL治疗178例;观察比较3组手术时间、住院时间、结石清除率、术后并发症发生率及复发率。结果 RLU组的结石清除率(98.54%)高、术后并发症发生率(0.97%)低;手术时间及住院时间较少;RLU术后复发率与其他2组差异无统计学意义。结论 后腹腔镜输尿管切开取石治疗复杂输尿管上段结石结石清除率高,并发症少,输尿管狭窄的发生率低,适用于复杂输尿管上段结石并且合并尿路感染的患者。
关键词:  复杂输尿管上段结石  后腹腔镜切开取石术  输尿管镜取石术  经皮肾镜取石术  临床疗效和安全性
DOI:10.16118/j.1008-0392.2019.06.013
投稿时间:2019-04-25
基金项目:国家自然科学基金(81870517);上海市科学技术委员会科研计划项目(18140900302)
Comparison of efficacy and safety of three different minimally invasive procedures for treatment of complicated upper ureteral calculi
WANG Ke-yi, , , , , ,,WANG Guang-chun,HUANG Jian-hua,ZHANG Hai-min,YIN Lei,SHI Heng,HUANG Tian-run,PENG Bo
(Dept. of Urology, Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China)
Abstract:
Objective To compare the clinical efficacy and safety among retroperitoneal laparoscopic ureterolithotomy(RLU), ureteroscopic lithotripsy(URL) and percutaneous nephrolithotomy(PCNL) for treatment of complex upper ureteral calculi. Methods Clinical data of 585 patients with complicated upper ureteral calculi admitted from January 2006 to December 2017 were retrospectively analyzed. Among 585 patients, 206 cases were treated with RLU, 201 were treated with URL, and 178 were treated with PCNL. The operation time, length of hospital stay, stone clearance rate, postoperative complication rate and recurrence rate of the three groups were observed and compared. Results The stone clearance rate(98.54%) was higher and postoperative complication rate was lower(0.97%) in the RLU group than those of other two groups(P<0.05 or <0.01).The operation time [(50.36±18.72) min] and length of hospital stay [(8.23±2.44) days] in the RLU group were shorter than those in other two groups(P<0.05 or <0.01). There was no significant difference in recurrence rate among three groups(P>0.05). Conclusion RLU has advantages of higher stone clearance rate, lower complication rate, shorter operation time and length of hospital stay in the treatment of upper ureteral calculi, compared with URL and PCNL.
Key words:  complex upper ureteral calculi  retroperitoneal laparoscopic ureterolithotomy  ureteroscopic lithotripsy  percutaneous nephrolithotomy  clinical efficacy and safety

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