腹腔镜输尿管重建在子宫手术所致输尿管损伤中的应用

doi:10.3969/j.issn.1005-6483.2019.05.021

摘要/Abstract

摘要： 目的:探讨腹腔镜重建技术用于治疗子宫手术所致输尿管损伤的临床疗效。方法:子宫手术所致输尿管损伤病人20例，均采用腹腔镜技术进行处理，选择经腹腔入路，首先在髂外动脉前方或上方找到输尿管，完全游离输尿管下段，于损伤部位上方1cm处将其切断，输尿管与膀胱行乳头吻合。结果:平均手术时间96分钟，无中转开放手术，无输血，无严重并发症。术后随访4～26个月，5例有轻度肾积水，1例左侧输尿管口狭窄行球囊扩张治疗后好转。结论:腹腔镜输尿管重建治疗子宫手术输尿管损伤，创伤小，安全性高，疗效确切。

关键词: 输尿管损伤, 输尿管重建, 子宫手术, 腹腔镜

Abstract: Objective:To investigate the clinical efficacy of laparoscopic ureteral reconstruction to treat ureteral injury caused by uterectomy.Methods:20 patients with ureteral injury caused by uterectomy were treated laparoscopically by transperitoneal approach.The ureter was first found supine or above the external iliac artery.Distal ureter was completely dissociated.The ureter was cut off 1cm above the injury site，then ureter was anastomosed to the bladder.〖WTHZ〗Results:The average operation time was 96 minutes.All cases were done by laparoscopic，no blood transfusion and no other serious complications occurred.Follow up was done for 4 to 26 months and 5 of them had mild hydronephrosis and 1 of them had left ureteral orifice stenosis which was been cured after balloon dilation.Conclusion:Laparoscopic ureteral reconstruction is a mini invasive，safe and effective method to treat ureteral injury after hysterectomy andshowed a good clinical value.

Key words: ureteral injury, ureteral reconstruction, uterectomy, laparoscopic

王彬, 李炯明, 方克伟, 刘建和, 王光, 段飞. 腹腔镜输尿管重建在子宫手术所致输尿管损伤中的应用[J]. 临床外科杂志, 2019, 27(5): 427-428.

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