妇科手术致输尿管损伤腹腔镜一期处理探讨（附5例报告）

Early laparoscopic management of ureteral injury during gynecological surgeries

目的探讨妇科手术致输尿管损伤的腹腔镜一期处理的治疗效果。方法回顾性分析腹腔镜一期处理的5例妇科手术致输尿管损伤患者的临床资料和治疗结果。结果5例患者，术后2-10天发现，均行膀胱美篮试验，排除膀胱瘘，行膀胱镜下输尿管逆行插管有造影剂外渗，证实为输尿管中、下段瘘。4例行输尿管端端吻合＋双J管置入术，1例行输尿管膀胱黏膜下隧道再植，并留置双J管。5例患者术后住院4—7天，平均5天；术后1-2个月自膀胱内取出双J管，IVU检查示输尿管吻合处通畅，患肾形态、功能正常。结论对妇科手术致输尿管损伤患者，腹腔镜一期处理临床效果好。

Objectives To explore the therapeutic efficacy of early laparoscopic management of ureteral injury during gynecological surgeries. Methods The clinical datas and the results of treatment in 5 patients with ureteral injury during gynecological surgeries were analyzed restropectively. Results All cases were found during operation at 2 -10 days after injury. Of 5 cases who were found after injury, 4 cases were treated with end to end ureteral anastomosis and 1 case with ureteroneocystostomy. The hospitalization time after surgery was 4 - 7 days, average 5 days. The double J stents were removed after 1 - 2 months and the IVU showed that shape and function of patient kidneys were normal. Conclusions We conclude that early laparoscopic ureteral injury repair is feasible, safe, effective.