Gutiérrez García R, Roca Edreira A, Martín García B, Hernández Rodríguez R, Portillo Martín J A, Gutiérrez Baños J L, Correas Gómez M A, del Valle Schaan J I, Villanueva Peña A, de Diego Rodríguez E
Servicio de Urología, H.U. Marqués de Valdecilla, Santander, Cantabria.
Actas Urol Esp. 1999 Apr;23(4):327-32.
To carry out a revision of iatrogenic ureteral damage during open surgery occurred in our hospital over a 10-year period, to review the literature and to contrast the results.
Between January 1987 and December 1996, 19 cases of iatrogenic ureteral damage were reported in 18 patients. Ureteral damage was the result of gynaecological surgery in 8 cases (42%), general surgery in 5 cases (26.5%), vascular surgery in 4 cases (21.1%) and urological surgery in 2 cases (10.5%). Four patients had been given radiotherapy. In 15 of the ureteral units involved, reconstructive open surgery was performed while the remaining 4 units received conservative therapy.
In 11 cases of open surgery the results were good, 2 cases are nephrostomy carriers and 2 underwent nephrectomy. Conservative treatment was resolutive in all instances.
Gynaecological and general surgery are the major causes of ureteral iatrogeny in our media. In more than half the cases, diagnosis is late. Radiotherapy was associated to late diagnosis in all cases. When diagnosed early, both surgical and conservative therapy achieve good results.
对我院10年间开放手术中发生的医源性输尿管损伤进行回顾性研究，复习相关文献并对比结果。
1987年1月至1996年12月，18例患者中有19例医源性输尿管损伤报告。输尿管损伤的原因包括妇科手术8例（42%）、普通外科手术5例（26.5%）、血管外科手术4例（21.1%）和泌尿外科手术2例（10.5%）。4例患者曾接受放疗。15个受累输尿管单位进行了开放性重建手术，其余4个单位接受了保守治疗。
11例开放手术效果良好，2例为肾造瘘患者，2例接受了肾切除术。所有保守治疗均有效。
在我们的医疗环境中，妇科和普通外科手术是医源性输尿管损伤的主要原因。超过半数病例诊断较晚。所有病例中放疗均与诊断延迟相关。早期诊断时，手术和保守治疗均能取得良好效果。
