自制发光输尿管导管系统在腹腔镜手术中预防输尿管损伤的临床应用  

Clinical application of self-made luminous ureteral catheter system in the prevention of ureteral injury in laparoscopic surgery

作　　者：孟安启[1] 李咏梅[2] 张昌庆[1] 胡志涛[3] 周保成[1] 陈华萍[1] 陈卫东[1] 杨建国[1] 李正平[1] 

机构地区：[1]湖北省襄樊市解放军第477医院外四科,441023 [2]广东省广州市中山大学附属第三医院儿科,510630 [3]湖北省襄樊市航空航天部第364医院泌尿外科,441023

出　　处：《中华腔镜泌尿外科杂志（电子版）》2010年第2期8-9,共2页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨自制发光输尿管导管系统在腹腔镜手术中预防医源性输尿管损伤的有效性。方法腹腔镜手术操作前,在膀胱镜直视下向输尿管插入发光输尿管导管系统约22～30cm(因人而异),术中由助手协助操作间歇或连续按压电钮让已插入输尿管导管发光便于术者辨认或者避开输尿管。结果66例输尿管上段结石,22例肾盂结石都能准确快速找到病变部位,避免损伤周围血管;106例子宫切除术无1例损伤输尿管;22例直肠肿瘤手术(包括2例粘连严重腹腔镜下无法顺利完成手术改开放手术)均未损伤输尿管。结论腹腔镜下微创手术应用自制发光输尿管导管系统能有效预防医源性输尿管损伤。Objective To explore the efficacy of the self-made luminous ureteral catheter system in preventing iatrogenic ureteral injury in laparoscopic surgery. Methods A luminous ureteral catheter system was inserted about 22-30cm along the ureter under direct vision before laparoscopic surgery. The assistant pressed the button intermittently or continuously to lighten the inserted catheter that help the operator to identify or avoid the ureter during the operation. Results The lesion could be located quickly and accurately and the peripheral blood vessels were protected in 66 cases with calculus in upper ureter and 22 cases with calculus in renal calyx. There was no ureteral injury in 106 cases with hysterectomy and 22 cases with rectal cancer surgery （including 2 cases with severe adhesion that could not be completed successfully by the laparoscopic surgery and then changed to open surgery）. Conclusions Self-made luminous ureteral catheter system can prevent iatrogenic ureteral injury effectively in minimally invasive laparoscopic surgery.

关 键 词：发光输尿管导管系统 腹腔镜 输尿管损伤 

分 类 号：R699[医药卫生—泌尿科学]