Abstract：【Objective】To investigate the risk factors of ureteral stricture after retroperitoneal laparoscopic ureterolithotomy (RLU) in the treatment of ureteral calculi. 【Methods】The clinical data of 501 patients with ureteral calculi who were treated with RLU from February 2016 to August 2019 were analyzed retrospectively. According to whether there was ureteral stenosis after operation, they were divided into observation group (postoperative ureteral stenosis,n=26) and control group (no postoperative ureteral stenosis,n=475). The patients were followed up for 1 year. The situation of ureteral stenosis after RLU was counted, and the factors affecting ureteral stenosis after RLU were analyzed by logistic regression. 【Results】 Total of 26 cases (5.19%) of 501 patients with ureteral calculi treated by RLU were complicated with ureteral stenosis, including 21 patients with proximal ureteral stenosis, 5 patients with distal ureteral stenosis, and the remaining 475 patients had no ureteral stenosis. Univariate analysis showed that the course of stone incarceration, stone diameter and degree of hydronephrosis were the influencing factors of ureteral stenosis after RLU (P<0.05). Logistic multivariate analysis showed that the course of stone, stone diameter and degree of hydronephrosis were the influencing factors of ureteral stenosis after RLU (P<0.05). 【Conclusion】 The risk of ureteral stricture after RLU is high in patients with ureteral calculi. The course of stone, stone diameter and degree of hydronephrosis are the risk factors of ureteral stricture after RLU.
[1] WANI M M, DURRANI A M. Laparoscopic ureterolithotomy: Experience of 60 cases from a developing world hospital[J].J Minim Access Surg,2018, 15(2):103-108. [2] NAGHIYEV R N, IMAMVERDIYEV S B, SANLI O M. Results of laparoscopic ureterolithotomy depending on the type of laparoscopic approach and location of the stone[J].Urologiia,2018, 3(1):121-125. [3] DONG H, PENG Y, LI L, et al. Prevention strategies for ureteral stricture following ureteroscopic lithotripsy[J].Asian J Urol,2018, 5(2):94-100. [4] LAMB C R, CORTELLINI S, HALFACREE Z. Ultrasonography in the diagnosis and management of cats with ureteral obstruction[J].J Feline Med Surg,2018, 20(1):15-22. [5] BALABAN M, OZKAPTAN O, SEVINC C, et al. Minimally invasive approach to ureteral stricture in transplant kidney by periodic retrograde ureteral stent placement and exchange[J].Transplant Proc,2018, 50(10):3405-3410. [6] ARPALI E, AL-QAOUD T, MARTINEZ E, et al. Impact of ureteral stricture and treatment choice on long-term graft survival in kidney transplantation[J].Am J Transplant,2018, 18(8):1977-1985. [7] 叶照华, 米其武, 罗杰鑫, 等. 输尿管结石行输尿管镜下碎石术后并发输尿管狭窄的危险因素分析[J].中华腔镜泌尿外科杂志(电子版),2017,11(1):40-42. [8] ZHAO P. Endoscopic management of ureteral stricture: nyu case of the month, August 2018[J].Rev Urol,2018, 20(3):140-142. [9] 张志成, 廖继强. 输尿管镜下钬激光碎石术后输尿管狭窄的危险因素分析[J].中国药物与临床, 2020, 20(8):1270-1272. [10] 李世强, 侯建平, 吴宪伟, 等. 后腹腔镜下输尿管上段结石切开取石术后并发症临床分析[J].山西医药杂志, 2018, 47(5):550-552. [11] RAO D, YU H, ZHU H, et al. Percutaneous nephrostomy via the central venous catheter in combination with selective ureteroscopic lithotripsy for the treatment of ureteral stones in the middle-upper segment[J].J Cancer Res Ther,2018, 14(3):567-569.
2022, Vol. 39 
