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題 名 | Technique Modifications in Retroperitoneoscopic Ureterolithotomy for Impacted Upper Ureteral Stones=以改進之後腹腔鏡輸尿管截石術處理嵌塞之上段輸尿管結石 |
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作 者 | 闕士傑; 陳淳; 陳世乾; 蕭博仁; 丘祖毅; 賴明坤; | 書刊名 | 中華民國泌尿科醫學會雜誌 |
卷 期 | 9:4 1998.12[民87.12] |
頁 次 | 頁186-190 |
分類號 | 416.274 |
關鍵詞 | 後腹腔鏡手術; 輸尿管截石術; 輸尿管結石; Retroperitoneoscopy; Ureterolithotomy; Ureteral stone; |
語 文 | 英文(English) |
中文摘要 | 我們以改進之後腹腔鏡輸尿管截石術成功地處理了七位中的五位嵌塞在上段輸尿 管的結石病患。 我們對以往手術方式的改進之處在於:1. 在後腹腔鏡手術中,不再改變體 位,在直視下將輸尿管雙丁導管調整到最佳的位置。 2. 在內視鏡直視下,將輸尿管切口以 腔內縫合並打結的方式予以關閉。所有五位病人出院時均無體外之引流管。這五位病人手術 前後的資料並與十位進行傳統上輸尿管截石術的病人加以比較。 平均手術時間 (2.1 及 3.45 小時 ) 以傳統開刀方式較快 (P<0.05)。失血量上兩組之間無明顯差距。 術後需要的 針注止痛劑量 (60 及 175 毫克之 meperidine hydrochloride) 以後腹腔鏡組較少。 術後 的住院天數( 3.8 及 8.9 天), 及康復到日常生活( 9.5 及 24 天)也以後腹腔鏡組較 快(三者均 p<0.05 )。我們的結論是改進之後腹腔鏡輸尿管截石術因其侵襲性小,很適合 用來治療原來打算以傳統開刀方式處理的上輸尿管結石。 |
英文摘要 | Retroperitoneoscopic ureterolithotomy was successfully performed in five of seven patients with calculi impacted in the upper ureter. Our modifications of previously reported procedures included well adjustment of the position of the double-J ureteral stent under direct vision during the retroperitoneoscopic surgery without further posture change and suturing the ureterotomy incision with intracorporeal knotting. All these 5 patients were discharged without carrying external tubes or bags. Peri-operative parameters in these successful cases were compared with those in 10 cases of traditional open ureterolithotomy. The average operative time was shorter (2.1 vs. 3.45 hours; P<0.05) for the open ureterolithotomy group. The amount of mean blood loss did not differ between these two groups. The need for post-operative pareneral analgesics (60 vs. 175 mg of meperidine hydrochloride) was less; and post-operative hospital stay (3.8 vs. 8.9 days) and convalescence to regular daily activities (9.5 vs. 24 days) were much faster in the retroperitoneoscopic group (all P<0.05). Retroperitoneoscopic ureterolithotomy, with its minimal invasiveness, is a valuable alternative in the management of upper ureteral stones, especially when open ureterolithotomy is indicated. |
本系統中英文摘要資訊取自各篇刊載內容。