妇科腹腔镜手术后输尿管阴道瘘的诊治策略  

Strategy of Diagnosis and Management on the Ureterovaginal Fistula after Laparoscopic Gynecological Surgery

作　　者：任宇[1] 于广海[1] 杜浩[1] 王艳龙[1] 李天明[1] 王伟[1] REN Yu YU Guang-hai DU Hao et al(Department of Urology, Dalian Municipal Central Hospital, Oalian 116033, China)

机构地区：[1]大连市中心医院泌尿外科,辽宁大连116033

出　　处：《医学与哲学（B）》2016年第12期40-42,共3页Medicine & Philosophy(B)

摘　　要：探讨妇科腹腔镜手术后输尿管阴道瘘的诊治策略。选取笔者所在科室收治的17例妇科腹腔镜手术后输尿管阴道瘘患者,其中1例合并膀胱阴道瘘。其中行腹腔镜子宫切除3例,腹腔镜广泛子宫切除加盆腔淋巴结清扫13例,腹腔镜子宫阔韧带肿瘤切除1例。患者均表现为阴道有液体不自主流出,发生于术后6天~21天,平均10.8天。伴腹痛9例,发热3例。就诊时间为出现尿液漏出第3天~30天,平均13.3天。结果 8例行输尿管镜下留置双J管,治愈5例。12例行输尿管膀胱再植术,均治愈。妇科腹腔镜手术后输尿管阴道瘘一经诊断明确,需及时行输尿管镜探查,可选择合适患者行留置输尿管支架管治疗。To investigate the diagnosis and the management of the ureterovaginal fistula after laparoscopic gynecological surgery.Data were retrospectively reviewed for 17 cases of ureterovaginal fistula after laparoscopic gynecological surgery.Laparoscopic hysterectomy was performed in 3cases,Laparoscopic radical hysterectomy and pelvic lymphadenectomy was performed in 13 cases,laparoscopic tumor resection of broad ligament was performed in 1case.The clinical presentation is urinary leakage from vagina after laparoscopic gynecological surgery.Ureteroscopic stenting was accomplished in 8cases,5cases were healed.Ureteral reimplantation was accomplished in 12cases;all of the cases were healed.Once the diagnosis of ureterovaginal fistula was determined after laparoscopic gynecological surgery,the ureteroscopic exploration must be performed immediately.Ureteral stenting was performed in the suitable patients.

关 键 词：妇科 腹腔镜 输尿管阴道瘘 

分 类 号：R693[医药卫生—泌尿科学]