清宫术致输尿管全段撕脱伤1例报告

Total ureteral avulsion caused by uterine evacuation:a case report

输尿管全段撕脱主要见于输尿管镜操作所致,因清宫术所致的输尿管全段撕脱罕见。本文报道1例因清宫术致输尿管全段撕脱的病例,全麻下行回肠代输尿管术,手术效果良好。清宫术是一种常规、风险较低的手术方式,但也可能导致输尿管全段撕脱、膀胱破裂等严重并发症。对于高危清宫术患者,可采用B超引导下定位、术前预置输尿管支架等预防措施,避免此类严重并发症的发生。若发生输尿管全段撕脱,回肠代输尿管术是一种可行、有效的治疗方法。

Currently,the total ureteral avulsion are mainly secondary to ureteroscopy,and it is rarely caused by uterine evacuation clinically.This paper reported a case of total ureter avulsion after uterine evacuation,treating by ileal replacement for ureter under general anesthesia,and the surgical outcome was good.Uterine evacuation is a routine,less risky procedure,but it also can lead to serious complications such as total ureteral avulsion or bladder rupture.For potential high-risk patients with uterine evacuation,preventive measures such as accurate localization under B-ultrasound guidance or pre-operative ureteral stents indwelling are useful to avoid the occurrence of such serious complications.If total ureteral avulsion occurs,ileal replacement for ureter is a viable and effective treatment.