Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 2010;89(1):82-6. doi: 10.3109/00016340903433974.
Iatrogenic ureteral injury during pelvic surgical procedures is a well-known complication and important cause of morbidity. The authors investigated the circumstances surrounding registered ureteral injuries in order to identify potential opportunities to prevent such injuries.
Evaluation of claims concerning ureteral injuries reported to the Danish Patient Insurance Association.
Danish Patient Insurance Association.
All registered claims for ureteral injuries from 1996 to 2006.
Retrospective study of medical records and data from Danish Patient Insurance Association.
Preventable ureteral injuries.
From 1996 to 2006, 136 submitted claims concerning ureteral injuries were registered. Among these, 73 claims were approved (54%), and compensation paid. In 44 of these, the injury was caused by negligence. Failure to dissect the ureter despite indications for this procedure was the most common type of negligence. Laparotomy procedures were associated with 107 injuries (79%) and 29 injuries (21%) were caused during laparoscopic procedures. Thirty-four patients suffered from chronic renal dysfunction on the affected side. Only 17 of the ureteral injuries were discovered during the procedure.
Forty-four ureteral injuries could potentially have been avoided using established surgical practices, most importantly by exposing the ureter via dissection when indicated. Most of the ureteral injuries were discovered postoperatively.
在盆腔手术过程中，医源性输尿管损伤是一种众所周知的并发症，也是发病率的重要原因。作者调查了输尿管损伤的发生情况，以确定预防这些损伤的潜在机会。
对丹麦患者保险协会报告的输尿管损伤索赔进行评估。
丹麦患者保险协会。
1996 年至 2006 年所有报告的输尿管损伤的注册索赔。
对丹麦患者保险协会的医疗记录和数据进行回顾性研究。
可预防的输尿管损伤。
1996 年至 2006 年，共登记了 136 份输尿管损伤的索赔。其中，73 份索赔获得批准（54%）并支付了赔偿。在这些索赔中，44 份是由于疏忽造成的。尽管有进行此手术的指征，但未进行输尿管解剖是最常见的疏忽类型。剖腹手术导致 107 例损伤，腹腔镜手术导致 29 例损伤。34 名患者在受影响侧患有慢性肾功能不全。只有 17 例输尿管损伤是在手术过程中发现的。
如果采用既定的手术方法，其中最重要的是在有指征时通过解剖暴露输尿管，可以避免 44 例输尿管损伤。大多数输尿管损伤是在术后发现的。
