腹腔镜辅助阴式子宫切除术泌尿系统损伤5例报告  

Urinary injuries in laparoscopic-assisted vaginal hysterectomy: A report of 5 cases

作　　者：冯静[1] 李晓伟[1] 周蓉[1] 王世军[1] 崔恒[1] 王建六[1] 

机构地区：[1]北京大学人民医院妇科,北京100044

出　　处：《中国微创外科杂志》2007年第3期230-232,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的 总结腹腔镜辅助阴式子宫切除术(laparoscopic-assisted vaginal hysterectomy,LAVH)泌尿系统损伤的教训与处理经验.方法 回顾分析我院1995年12月～2006年1月415例LAVH中5例出现泌尿系统损伤的临床资料.结果 术中2例膀胱损伤;术后3例输尿管损伤:2例术后第4天出现腹痛而发现,1例术后30d因无症状阴道大量排液发现.并发症发生率1.2%(5/415).结论 LAVH并发症高危因素有肿瘤直径＞5 cm,肿瘤突向阔韧带及接近宫颈峡部水平,手术修补是主要的治疗方式.Objective To investigate urinary tract injuries in laparoscopic-assisted vaginal hysterectomy(LAVH).Methods Clinical data of 5 cases of urinary tract injuries from 415 cases of LAVH from December 1995 to January 2006 in this hospital were retrospectively studied. Results Intraoperative bladder injury occurred in 2 cases and an immediate repair was given.Postoperative ureteral injury occurred in 3 cases: 2 cases of ureteral injury were found 4 days after operation because of abdominal pain,and 1 case was found on the 30th day after operation because of massive vaginal discharge.Conclusions Urinary tract injury is one of common complications in laparoscopic-assisted vaginal hysterectomy.High-risk factors include tumor size more than 5 cm,tumor protruding to the broad ligament,and tumor adjacent to the isthmus.Surgical repair is the major treatment.

关 键 词：腹腔镜辅助阴式子宫切除术 泌尿系损伤 输尿管阴道瘘 

分 类 号：R713[医药卫生—妇产科学]