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目的:探讨输尿管镜检术及输尿管插管在盆腔复杂手术输尿管损伤的预防及早期诊治中的可行性。方法:回顾分析我院2007年3月至2013年1月期间23例盆腔复杂开放及腹腔镜手术患者。结果:15例术前行输尿管镜检查,发现1例宫颈癌患者双侧输尿管下段受侵犯,宫颈癌根治术中将下段病变输尿管一并切除后行输尿管膀胱再植术,14例输尿管置管、术中无一例发生输尿管损伤。8例术前未行输尿管镜检查,7例术中怀疑输尿管损伤,术中行输尿管镜检查,诊断输尿管损伤3例,另1例术后3周出现腰痛,行输尿管镜检查诊断为输尿管损伤。结论:对于盆腔复杂开放及腹腔镜手术患者,行输尿管镜检查或输尿管置管,可有效防止输尿管损伤、及时诊治输尿管损伤,手术操作安全。
Objective: To investigate the feasibility of ureteroscopy and ureteral intubation in the prevention and early diagnosis and treatment of ureteral injury complicated by pelvic surgery. Methods: A retrospective analysis of our hospital from March 2007 to January 2013 period of 23 patients with pelvic open complicated laparoscopic surgery. Results: 15 cases underwent preoperative ureteroscopy and found that 1 case of cervical cancer patients underwent bilateral ureteral invasion, uterine cervix cancer radical surgery will be combined with removal of the ureter after bladder ureter resection, 14 cases of ureteral catheterization, No case of ureteral injury occurred. Ureteroscopy was not performed in 8 cases. Ureteral injury was suspected in 7 cases. Ureteroscopy was performed in 3 cases. Ureteral injury was diagnosed in 3 cases. The other 1 case showed back pain in 3 weeks after operation. Ureteroscopy was used to diagnose ureteral injury. Conclusion: For patients with complex open pelvis and laparoscopic surgery, ureteroscopy or ureteral catheterization can effectively prevent ureteral injury and timely diagnosis and treatment of ureteral injury, and the operation is safe.