输尿管子宫内膜异位症继发的肾脏隐匿性丧失
Silent loss of kidney seconary to ureteral endometriosis.
作者信息
Nezhat Camran, Paka Chandhana, Gomaa Mona, Schipper Erica
机构信息
Center for Special Minimally Invasive Surgery, Stanford University Medical Center, Palo Alto, CA 94304, USA.
出版信息
JSLS. 2012 Jul-Sep;16(3):451-5. doi: 10.4293/108680812X13462882736213.
BACKGROUND
Ureteral endometriosis is a serious localization of disease burden that can lead to urinary tract obstruction, with subsequent hydroureter, hydronephrosis, and potential kidney loss. Diagnosis is elusive and relies heavily on clinical suspicion as ureteral endometriosis can occur with both minimal and extensive disease. Surgical technique to treatment varies, but the goal is to salvage renal function and decrease disease burden.
CASE DESCRIPTIONS
We describe 3 cases in which there was documentation of renal atrophy and function loss with subsequent workup and surgical intervention.
RESULTS
The cases illustrate varying surgical approaches tailored to localization of ureteral endometriosis. All cases were carried out laparoscopically.
CONCLUSION
Ureteral endometriosis, albeit rare, can be complicated by potential loss of renal function. Clinical suspicion and preoperative assessment may help with diagnosis and allows for a multidisciplinary preconsultation. Laparoscopic surgical approach is based on extent of disease and localization and can be carried out successfully in the hands of a highly experienced laparoscopic surgeon.
背景
输尿管子宫内膜异位症是疾病负担的一种严重表现形式，可导致尿路梗阻，继而引发输尿管积水、肾盂积水，并可能导致肾脏丧失。诊断较为困难，严重依赖临床怀疑，因为输尿管子宫内膜异位症可在疾病轻微和广泛时均出现。治疗的手术技术各不相同，但目标是挽救肾功能并减轻疾病负担。
病例描述
我们描述了3例经检查及手术干预后记录有肾萎缩和功能丧失的病例。
结果
这些病例说明了针对输尿管子宫内膜异位症定位所采用的不同手术方法。所有病例均通过腹腔镜进行。
结论
输尿管子宫内膜异位症虽罕见，但可能并发肾功能丧失。临床怀疑和术前评估有助于诊断，并可进行多学科术前会诊。腹腔镜手术方法基于疾病范围和定位，在经验丰富的腹腔镜外科医生手中可成功实施。
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