医源性输尿管下段损伤的处理

Treatment strategies of iatrogenic lower ureteral injuries:ten cases report

目的:探讨医源性输尿管下段损伤的原因、诊断、二期手术及治疗经验。方法:总结分析10例医源性输尿管下段损伤处理的临床资料。结果:10例医源性输尿管下段损伤患者中,妇产科9例、泌尿外科1例。二期修复手术方式包括联合肾穿刺造瘘、输尿管膀胱再植和放置双J管引流。随访6～42个月,仅1例出现肾积水;所有患者输尿管通畅,尿漏消失,肾功能正常。结论:医源性输尿管损伤只要一般情况良好,均可行修复手术。输尿管膀胱再吻合是治疗输尿管下段损伤的首选方法之一。

Objective： To investigate the cause,diagnosis,secondary operation and treatment experiences of iatrogenic lower ureteral injury.Methods：The clinical data of 10 patients with iatrogenic lower ureteral injury were analyzed.Results：Among the 10 cases of iatrogenic lower ureteral injury,9 cases were from the Department of Obstetrics and Gynecology,1 case was from the Department of Urology.The secondary repair operations included the combined renal puncture fistula,ureteroneocystostomy,and double J-tube drainage.After 6 to 42 months of follow-up,only 1 patients had mild hydronephrosis,whereas the ureters of all patients were smooth,the urinary leakage disappeared,and the renal function was normal.Conclusions：As long as the general situation of the patients with iatrogenic ureteral injuries is good,repair surgery is feasible.Ureteroneocystostomy is one of the preferred methods for the treatment of iatrogenic lower ureteral injury.