腹腔镜广泛子宫切除术输尿管并发症6例分析

目的评估腹腔镜广泛子宫切除术输尿管损伤的风险及避免损伤的手段。方法回顾性分析我院妇科2006年3月-2009年12月开展的腹腔镜广泛子宫切除359例,回顾性分析输尿管损伤发生率及诊断、处理方法。结果共发生输尿管损伤6例,发生率约为1.68%,2例术中发现并在术中行腹腔镜下输尿管膀胱移植术、双J管置入术;4例在术后7-12d内发现输尿管瘘得以诊断,1例行双肾盂造瘘后自行愈合,2例行开腹输尿管膀胱移植,1例经膀胱镜置入双J管愈合。结论腹腔镜广泛子宫切除术的输尿管损伤发生率与传统手术相当,经过严格培训和临床经验增加,可以降低输尿管损伤的发生率。

Ureteral complications of laparoscopic radical hysterectomy:A report of 6 cases

Objective To evaluate the risk of ureteral injuries caused by radical hysterectomy and how to avoid it.Methods The incidence,diagnosis and treatment of ureteral injuries caused by radical hysterectomy performed in March 2006-December 2009 for 359 patients were retrospectively analyzed.Results Ureteral injury occurred in 6 patients,with an incidence of 1.68%.Ureteral injury found in 2 patients during operation was treated with laparoscopic ureterovesical transplantation and double J tube implantation.Ureteral fistula found in 4 patients 7-12d after operation was treated with pyelostomy,laparoscopic ureterovesical transplantation,double J tube implantation,respectively,in 1,2,and 1 patients.All the injuries were healed after treatment.Conclusion The incidence rate of ureteral injury is similar after laparoscopic radical hysterectomy and traditional surgical operation,which can be reduced by training the surgeons.