腹腔镜下宫颈癌根治术致泌尿系统脏器损伤的原因及预防  

The reason and prevention of genitourinary organ secondary to laparoscopic radical hysterectomy in the early cervical cancer

作　　者：申沛[1] 朱前勇[1] 郭伟平[1] 赵洪伟[1] 朱芳芳[1] 

机构地区：[1]中国人民解放军第一五二中心医院妇产科,河南平顶山467000

出　　处：《中国内镜杂志》2014年第11期1168-1171,共4页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜下宫颈癌根治术致泌尿系统脏器损伤的原因及预防措施。方法回顾性分析2006年12月-2011年12月,在该院行腹腔镜下宫颈癌根治术致泌尿系统脏器损伤的14例患者临床资料。结果所有患者均在腹腔镜下实施手术,主要并发症包括:术中发生膀胱损伤4例,输尿管损伤2例;输尿管阴道瘘7例,其中术后早期输尿管阴道瘘1例,术后出现晚期输尿管阴道瘘6例;输尿管狭窄1例。结论腹腔镜下宫颈癌根治手术范围大,特别是在腹腔镜开展的初期,对镜下子宫颈周围解剖认识不足,且操作不熟练时容易出现泌尿系统脏器损伤并发症。熟悉局部解剖,提高手术操作技巧,积累手术经验是预防泌尿系损伤的关键。[ Objective ] To evaluate the reason and prevention of genitourinary organ secondary to laparoscopicradical hysterectomy in the early cervical cancer. [Methods] The medical records of laparoscopic radicalhysterectomy patients in the early cervical cancer between December 2006 and December 2011 were reviewedretrospectively.14 genitourinary injury cases caused by laparoscopic radical hysterectomy were analyzed. [Results]All patients were operated on by laparoscopic. Intraoperative and postoperative complications occurred in 14patients. 4 patients sustained bladder injuries, and 2 patients sustained urethral injuries intraoperatively.Ureterovaginal fistulas were identified in 7 patients postoperatively. Urethral stricture was identified in 1 patientpostoperatively. [ Conclusion ] Surgery related complications may usually occur in the initial stage of laparoscopicradical hysterectomy because of a larger surgery range, insufficient laparoscopic anatomical knowledge and unskillfuloperation. They will be reduced by mastering the local anatomy, improving operation skills and accumulatingexperience.

关 键 词：子宫颈癌 广泛性子宫切除术 腹腔镜 膀胱损伤 输尿管损伤 

分 类 号：R711[医药卫生—妇产科学]