Wu K, Wu Z, Han Z
Department of Urology, Beijing Red Cross Chaoyang Hospital Affiliated of Capital University of Medical Sciences.
Zhonghua Wai Ke Za Zhi. 1996 Dec;34(12):720-2.
Diagnosis and treatment of 17 patients who sustained 20 iatrogenic ureteral injuries were analyzed. Primary operations in which ureteral injury occurred are almost gynecologic procedures and general surgery. Injuries were managed by ureteroureterostomy in four, ureteral stent in one, removal suture ligation and ureteral double J-catheter in one, ureteroneocystostomy in ten, psoas-hitch technique and ureteroneocystostomy in one, nephrectomy in two. All patients with appropriate repair were followed-up periods of three to five years. Renal function of these patients had optimal results. When ureteral injury occurs, B-US, IVU, cystoscopy, retrograde ureterography or infusion of dye may be useful. An appropriate repair should be chosen according to length and position of ureteral injuries. Reoperation was optimal in two to three weeks. Immediate recognition of accidental ureteral injury provides optimal results. Patients with unrecognized injuries had suboptimal results.
对17例发生20处医源性输尿管损伤的患者的诊断和治疗进行了分析。发生输尿管损伤的初次手术几乎均为妇科手术和普通外科手术。损伤的处理方式为:输尿管输尿管吻合术4例,输尿管支架置入术1例,拆除缝线结扎并置入输尿管双J管1例,输尿管膀胱再植术10例,腰大肌悬吊技术加输尿管膀胱再植术1例,肾切除术2例。所有接受适当修复的患者均进行了3至5年的随访。这些患者的肾功能取得了最佳结果。当发生输尿管损伤时,B超、静脉尿路造影、膀胱镜检查、逆行输尿管造影或染料注入可能会有帮助。应根据输尿管损伤的长度和位置选择适当的修复方式。再次手术在两到三周内进行最佳。及时识别意外输尿管损伤可取得最佳结果。未被识别损伤的患者结果欠佳。