腹腔镜下全子宫切除并发输尿管损伤5例效果分析

目的：探讨腹腔镜下全子宫切除并发输尿管损伤的原因及防治。方法回顾性分析该院2014年1月-2016年1月所收治腹腔镜下全子宫切除并发输尿管损伤的5例病人临床资料。具体包括阴道排液时间、例数及发生原因等。结果5例在腹腔镜全子宫切除术后才出现不同程度阴道排液(漏尿),2例在术后3 d,2例在术后1周,1例在术后10 d。系在举宫杯的指引下单极电钩环形切开阴道穹窿造成热损伤输尿管膀胱壁内段所致。结论腹腔镜下全子宫切除并发输尿管损伤主要与手术者的熟练程度、设备条件及手术难度有关。

Analysis on 5 Cases of Laparoscopic Total Hysterectomy Complicated with Ureteral Injury

Objective To summarize the causes and prevention of laparoscopic total hysterectomy complicated with ureteral injury. Methods Retrospective analysis of the clinical data of 5 patients with ureteral injury in our hospital from January 2014 to January 2016.The time of vaginal discharge, the number of cases and the reasons of the occurrence of the vaginal discharge were included. Results 5 cases in laparoscopic total hysterectomy after the emergence of different degrees of vagi-nal discharge (leakage), 2 cases in the three day after the operation, 2 cases in the postoperative week, 1 cases in ten days af-ter surgery. The uterus lifting cup under the guidance of monopolar hook ring incision vaginal fornix heat damage caused by ureteral. Conclusion Laparoscopic total hysterectomy complicated with ureteral injury is mainly related to the proficiency of operator, equipment condition and operation difficulty. The prevention measures: attentions be paid to the ureteral anatomic location; fully separate the bladder outside the cervical mouth; choose energy equipment such as ultrasonic knife to minimalizing electronic damage; checking the ureteral contorts and peristalsis;when meet pelvic adhesion, preoperative placement of ureteral catheter is necessary.