Neuman M, Eidelman A, Langer R, Golan A, Bukovsky I, Caspi E
Department of Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
Surg Gynecol Obstet. 1991 Oct;173(4):268-72.
Iatrogenic injuries to the ureter are hazardous complications of pelvic and vaginal operations, causing severe morbidity and even mortality. Eighteen such instances that occurred during the last 30 years are analyzed. Most of the injuries were associated with attempts to achieve hemostasis without proper identification of the ureter. The incidence of ureteral injuries declined during the years concomitantly with the improvement of surgical techniques. The proper identification and, when necessary, isolation of the ureter during operations in which there is a risk is crucial in reducing the incidence of ureteral injuries. Those diagnosed at the time of injury and treated with end to end anastomosis had the best results. Delayed diagnosis and treatment were associated with poor end results. The English literature is reviewed.
医源性输尿管损伤是盆腔和阴道手术的危险并发症，可导致严重发病甚至死亡。本文分析了过去30年中发生的18例此类病例。大多数损伤与在未正确识别输尿管的情况下进行止血尝试有关。随着手术技术的改进，输尿管损伤的发生率在这些年中有所下降。在有风险的手术过程中，正确识别输尿管并在必要时进行分离对于降低输尿管损伤的发生率至关重要。那些在损伤时被诊断出并接受端端吻合术治疗的患者效果最佳。延迟诊断和治疗与不良的最终结果相关。本文还对英文文献进行了综述。
