腹腔镜结石手术:一位外科医生的经验

S. Çalışkan, M. Sungur
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引用次数: 1

摘要

背景:腹腔镜结石手术在解剖异常、伴输尿管盂连接处梗阻结石、憩室病症状性结石、埋伏性大肾结石及输尿管结石等方面具有一定优势。结果患者的特点和并发症接受腹腔镜手术进行评估和提出。方法:回顾性分析2014年1月至2016年6月腹腔镜手术治疗输尿管结石和肾结石的病例。所有患者均采用经腹膜法。在这种方法中;在离脐近1cm处切开以进入腹部。二氧化碳被用来制造气腹。记录手术时间、住院时间、术中及术后并发症发生情况。结果:女性2例,男性5例。患者平均年龄46.28 + 15.52岁,结石大小25.28 + 5.17 mm。平均住院时间4 + 3.94天。手术过程中无出血、脏器损伤等重大并发症。1例(% 14.28)转为开放手术。其余患者平均手术时间152 + 57.61分钟。结石游离率为100%。术中4例置入双j型支架,术后1例置入双j型支架。接受肾盂取石术的患者不需要放置支架。1例患者因引流时间长,术后发现输尿管狭窄,行经皮肾造口术(16.66%)。结论:腹腔镜结石手术成功率高。接受过腹腔镜基本训练的泌尿科医生可以成功完成腹腔镜手术。
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Laparoscopic Stone Surgery: One Surgeon Experience
Background: Laparoscopic stone surgery has some advantages in the anatomical anomalies, comcominant of ureteropelvic junction obstruction and stone, symptomatic stone of diverticulosis, impacted large renal and ureteral stones. The results of the patients’ characteristics and complications who underwent laparoscopic surgery were evaluated and presented. Methods: The patients who were treated by laparoscopic surgery from January 2014 to June 2016 for ureteral and kidney stone were reviewed retrospectively. Transperitoneal method was performed in all patients. In this method; near 1 cm from the umbilicus was incised for to access the abdomen. CO2 was used to create pneumoperitoneum. Operation time, duration of hospitalization, the complications were recorded during and after the surgery. Results: There are 2 female and 5 male patients. The mean age of the patients and stone size was 46.28 + 15.52 years and 25.28 + 5.17 mm respectively. Average hospital stay was 4 + 3.94 days. There was no major complications Such as bleeding, injury to internal organs During surgery. One patient (% 14.28) was converted to open surgery. The mean operation time of the remaining patients was 152 + 57.61 minutes. The stone free rate was 100%. Double j stent was inserted into four patient during the operation and one patient in postoperative period. The patients who underwent pyelolithotomy did not need stent placement. Percutaneousnephrostomy was performed in one patients because of prolonged drainage and ureteral stricture (16.66%) was detected in postoperative period. Conclusions: Laparoscopic stone surgery has a high succes rate. The urologist who were taken basic training of laparoscopy can be performed succesfully.
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