Boyd M E
Can J Surg. 1987 Jul;30(4):234-6.
Maintaining the integrity of the ureter is crucial in pelvic surgery. The ureter is best safeguarded by routine intraoperative exposure, which will also allow immediate recognition of injury to it. If doubts over possible injury persist, it is best to open the bladder. The flux of urine from the ureteric orifices or the retrograde passage of catheters will then confirm or deny clinical suspicions. If specialist help is unavailable, the pelvic surgeon must be able to perform simple ureteric repairs or temporize in a way that allows the safe delay of definitive surgery. End-to-end ureteric anastomosis and ureteroneocystostomy are straight-forward procedures that all pelvic surgeons should be familiar with. If they cannot be performed safely, the situation may be salvaged by draining the proximal ureter through the lateral abdominal wall; later, definitive surgery can be performed.
在盆腔手术中，保持输尿管的完整性至关重要。通过术中常规暴露输尿管能最好地保护它，这也能使术中及时发现输尿管损伤。如果对可能的损伤仍存疑虑，最好打开膀胱。输尿管口的尿液流出或导管的逆行插入将证实或排除临床怀疑。如果无法获得专科帮助，盆腔外科医生必须能够进行简单的输尿管修复或采取临时措施，以便安全延迟确定性手术。输尿管端端吻合术和输尿管膀胱再植术是所有盆腔外科医生都应熟悉的简单手术。如果无法安全进行这些手术，可以通过经侧腹壁引流近端输尿管来挽救局面；之后，再进行确定性手术。
