Matsubara Shigeki, Ohkuchi Akihide, Yashi Masahiro, Izumi Akio, Ohwada Michitaka, Kuwata Tomoyuki, Usui Rie, Kuwata Yoshimine, Nakata Manabu, Suzuki Mitsuaki
Department of Obstetrics and Gynecology, Jichi Medical University, Yakushiji Shimotsuke, Tochigi, Japan.
J Obstet Gynaecol Res. 2009 Apr;35(2):359-63. doi: 10.1111/j.1447-0756.2008.00941.x.
Cesarean hysterectomy for placenta previa percreta with bladder invasion often induces not only massive hemorrhage but also severe bladder/ureter injuries. A 37-year-old woman with previous cesarean delivery suffered placenta previa percreta with bladder invasion. At the 34th week, we performed cesarean hysterectomy. Without separating the bladder from the uterus/cervix, we incised the bladder lateral wall using an automatic stapling/cutting device, leaving the bladder posterior wall adhering to the uterus and resecting it with the uterus. The bladder was easily repaired without urological sequelae. We suggest a new, simple and safe technique for cesarean hysterectomy for this disease.
对于侵入膀胱的穿透性前置胎盘行剖宫产子宫切除术,不仅常引发大量出血,还会导致严重的膀胱/输尿管损伤。一名有剖宫产史的37岁女性患有侵入膀胱的穿透性前置胎盘。在孕34周时,我们实施了剖宫产子宫切除术。未将膀胱从子宫/宫颈分离,而是使用自动缝合/切割装置切开膀胱侧壁,使膀胱后壁与子宫相连,并与子宫一并切除。膀胱易于修复,未出现泌尿系统后遗症。我们为此病的剖宫产子宫切除术提出了一种新的、简单且安全的技术。