妇科手术中医源性下三分之一段输尿管损伤行腹腔镜下改良单纯输尿管膀胱再吻合术。

Laparoscopic modified simple ureteroneocystomy in iatrogenic lower third ureter injury during gynecology surgery.

机构信息

Department of Obstetrics and Gynecology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, Taiwan R.O.C; School of Medicine, Tzu Chi University, Hualien, Taiwan R.O.C.

Department of Urology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, Taiwan R.O.C.

出版信息

Taiwan J Obstet Gynecol. 2024 Sep;63(5):777-780. doi: 10.1016/j.tjog.2024.04.019.

DOI:10.1016/j.tjog.2024.04.019

PMID:39266165

Abstract

OBJECTIVE

Our objective was to propose a laparoscopic modified simple ureteroneocystostomy for repairing iatrogenic ureteral injuries. In laparoscopic modified simple ureteroneocystostomy, the highest point of the bladder was found by cystoscopy, then we implanted a "fish mouth" ureter end into the bladder, leaving at least 1 cm of ureter end in the bladder as an anti-reflux procedure.

CASE REPORT

We retrospectively reviewed a case series of lower third iatrogenic ureter injury during gynecology surgery of 11 patients who received laparoscopic modified simple ureteroneocystostomy at Da Lin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, from January 2011 to December 2020. One patient needs percutaneous nephrotomy due to infection and had the ureteroneocystostomy two months later. No obstruction, ureter stenosis/stricture, bladder leakage or other renal complications were noted after repair.

CONCLUSION

Laparoscopic modified simple ureteroneocystostomy is technically feasible for repairing lower third ureter injuries, with no major complications.

摘要

目的

我们的目的是提出一种腹腔镜改良的单纯输尿管膀胱吻合术，用于修复医源性输尿管损伤。在腹腔镜改良的单纯输尿管膀胱吻合术中，通过膀胱镜找到膀胱的最高点，然后将“鱼口”状的输尿管末端植入膀胱，在膀胱内至少留下 1 厘米的输尿管末端作为抗反流措施。

病例报告

我们回顾性分析了 2011 年 1 月至 2020 年 12 月在佛教慈济医疗基金会大林慈济医院接受腹腔镜改良单纯输尿管膀胱吻合术的 11 例妇科手术中下段医源性输尿管损伤患者的病例系列。1 例患者因感染而行经皮肾造口术，2 个月后行输尿管膀胱吻合术。修复后无梗阻、输尿管狭窄/梗阻、膀胱漏尿或其他肾脏并发症。