腹腔镜技术在医源性输尿管或膀胱损伤治疗中的应用(54例报告)

Outcome of laparoscopic repair in iatrogenic injury of ureter and bladder: follow-up of fifty-four cases

目的探讨腹腔镜技术在治疗医源性膀胱或输尿管损伤中的价值。方法采用回顾性分析2007年7月～2012年6月,收治54例医源性膀胱或输尿管损伤腹腔镜手术治疗效果,其中妇科手术损伤45例,泌尿外科损伤7例,普通外科损伤2例,手术包括膀胱修补、输尿管修补、输尿管端端吻合、输尿管膀胱再植及膀胱阴道瘘修补术等方法,所有患者随访1～24个月。结果所有患者均治愈,手术成功率100%,1例输尿管吻合术后7d出现盆腔积液,经阴道后穹窿引流痊愈。结论腹腔镜手术在治疗医源性膀胱或输尿管损伤较传统开放手术更具有显著优势,可最大限度的减少患者的创伤和痛苦。

Objective To evaluate the value of laparoscopic surgery in iatrogenic injury in ureter or bladder.Methods Retrospectively evaluated 54 patients who underwent laparoscopic repair for iatrogenic injury of ureter and bladder from July 2007 to June 2012 in signal hospital.The injury occurred with gynecological operation 45 cases,urological operation 7 cases,and abdominal surgery 2 cases.Surgery types included bladder repair,ureteral repair,end to end ureteral anastomosis,ureteroneocystostomy and vesicovaginal fistula repair.All patients followed up 1~24 months.Results All patients were cured,and the success rate of the operation is 100%,but after 5 days,1 case appeared pelvic effusion after ureteral anastomosis,while cured through vaginal vault drainage.Conclusion In the treatment of iatrogenic ureteral and bladder injury,Laparoscopic surgery has the more significant advantages than traditional open operation,which can maximum reduce the patients＇ trauma and pain.