宫颈癌、宫体癌手术泌尿道损伤12例分析

Clinical Analysis of 12 Cases with Urinary Tract Injury in Operation for Cervical Cancer and Endometrial Cancer

[目的]探讨宫颈癌手术输尿管膀胱损伤的原因及处理。[方法]回顾性分析1980年1月至2003年11月收治的宫颈癌、宫体癌手术所致膀胱输尿管损伤12例。[结果]4例在术中及时发现并成功修补,8例术后尿瘘,其中7例成功修补。[结论]盆腔局部手术不利因素是造成妇瘤手术泌尿道损伤的主要原因,及时修补输尿管是合适的,修补膀胱瘘必须先控制局部炎症。

To explore the reason and management of urinary tract injury in gynecologic surgery.From Jan.1980to Nov.2003,twelve patients with urinary tract injury during operation for cervical cancer or en-dometrial cancer were diagnosed and managed in our hospital.The data of the12patients were analyzed retrospective-ly.Four cases were indentified during operation and repaired successfully in time.Urinary fistula occurred postoperation in8patients.Seven cases of them were successfully repaired.[Conclusion]Urinary tract injury in gyneco-logical surgery is caused mostly by disadvantageous factors for surgery consisting in pelvic cavity.Early surgical repair is suitable for ureteral fistula caused by operation.It is necessary to control local infection well before the bladder fis-tula repaired.