Liapis A, Bakas P, Giannopoulos V, Creatsas G
University of Athens, Aretaieion Hospital, Greece.
Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(6):391-3; discussion 394. doi: 10.1007/pl00004045.
The purpose of this study was to review the cases of ureteric injuries during major pelvic surgery that occurred in our department over the last 15 years, in relation to possible predisposing factors and patient management according to the type of injury. From 5,122 major gynecologic operations we found 18 cases of ureteric injury, including 4 cases of urinoma. Parameters that were examined included the indication for surgery and the type of operation, coexisting pathological conditions, the position of and the delay in recognition of the ureteric damage. The incidence of ureteric injury was 0.35%. The time of recognition of injury in 9 cases was during primary surgery and end-to-end anastomosis was performed, whereas in the other 9 cases the injury was recognized after surgery and repair of the ureter was performed, with reimplantation into the bladder in 4 cases and end-to-end anastomosis in 5. Action to prevent the development of iatrogenic ureteral injury must be taken in advance, and the management of ureteric injuries could be improved with prompt recognition and repair by a skilled surgeon.
本研究的目的是回顾过去15年在我科发生的重大盆腔手术中输尿管损伤的病例，探讨可能的诱发因素，并根据损伤类型进行患者管理。在5122例重大妇科手术中，我们发现了18例输尿管损伤病例，其中包括4例尿瘤。研究考察的参数包括手术指征、手术类型、并存的病理状况、输尿管损伤的位置以及损伤的发现时间。输尿管损伤的发生率为0.35%。9例损伤在初次手术时被发现并进行了端端吻合，另外9例损伤在术后被发现并进行了输尿管修复，其中4例行输尿管膀胱再植术，5例行端端吻合术。必须提前采取措施预防医源性输尿管损伤的发生，由经验丰富的外科医生及时识别并修复输尿管损伤可改善其治疗效果。
