Manikandan Ramaswamy, Lynch Niall, Grills Richard J
Department of Urology, Basquill House, Stepping Hill Hospital, Stockport SK2 7JE, U.K.
J Endourol. 2003 Dec;17(10):945-7. doi: 10.1089/089277903772036343.
To demonstrate the safety and efficacy of percutaneous drainage of the peritoneal cavity using an 8F pigtail catheter placed under ultrasound guidance in cases of intraperitoneal perforation of the bladder as a result of transurethral resection of a bladder tumor (TURBT).
Three patients undergoing TURBT had inadvertent but significant intraperitoneal perforations of the bladder. All patients developed signs and symptoms of peritonism despite large catheters draining the bladder. An 8F pigtail catheter (Boston Scientific, Watertown, MD, USA) was inserted percutaneously under ultrasound guidance with local anesthetic infiltration.
All three patients made a good recovery without needing a laparotomy. Cystograms a week later confirmed an intact bladder. Clinical review revealed no sequelae as a result of the perforation or its treatment.
Percutaneous drainage of the abdomen in patients with intraperitoneal perforation of the bladder during TURBT is a safe alternative to laparotomy.
证明在经尿道膀胱肿瘤切除术(TURBT)导致膀胱腹腔内穿孔的病例中,在超声引导下使用8F猪尾导管进行经皮腹腔引流的安全性和有效性。
3例接受TURBT的患者意外发生了严重的膀胱腹腔内穿孔。尽管使用大导管引流膀胱,但所有患者均出现了腹膜炎的体征和症状。在局部麻醉浸润下,于超声引导下经皮插入一根8F猪尾导管(美国马萨诸塞州沃特敦市波士顿科学公司生产)。
所有3例患者均恢复良好,无需进行剖腹手术。一周后的膀胱造影证实膀胱完整。临床复查显示,穿孔及其治疗未导致任何后遗症。
TURBT期间膀胱腹腔内穿孔患者的经皮腹腔引流是剖腹手术的一种安全替代方法。