【摘要】 目的总结腹腔镜盆腔手术致泌尿系脏器损伤的原因、处理方法及预防措施。方法回顾性分析26例因腹腔镜盆腔手术致泌尿系脏器损伤的临床资料,包括普外科直肠手术3例、妇科手术23例;输尿管损伤21例、膀胱损伤5例。结果术中及时发现泌尿系损伤者7例,分别经内置双J管、输尿管端端吻合、输尿管或膀胱修补处理,均一期愈合,无并发症发生。术后发现泌尿系损伤者19例,其中膀胱阴道瘘3例,行耻骨上经膀胱修补成功;输尿管损伤16例,2例行逆行插管置双J管、14例行开放输尿管膀胱再植术治愈。结论腹腔镜盆腔手术创伤小、疗效高,提高手术操作技巧、积累经验有利于减少并发症的发生。更多还原

【Abstract】 Objective To summarize the clinical experience of prevention and management of genitourinary organ injury secondary to pelvic cavity laparoscopic surgery.Methods The treatment experience was analyzed in 26 genitourinary injury cases caused by pelvic cavity laparoscopic surgery from October 2001 to December 2008,which including 21 ureteral injury and five bladder injury.Results 7 cases of organ injury which were detected during the operation in time were healed by inserting double-J stent,end-to-end ureteral anastomosis and repairing of ureteral or bladder without any complications occurred.19 cases of genitourinary organ injury were found after the surgery,3 cases of them were vesicovaginal fistula were repaired transvesical approach successfully,the rest 16 cases were ureteral injury,2 cases were inserting double-J stent,14 cases received ureteral reimplantation.Conclusions Pelvic cavity laparoscopic surgery is an excellent method for treating pelvic organ diseases,with advantage of high efficacy;minimal invasion and rapid recovery.Surgery related complications will reduced by improving operation skills and accumulating experience.更多还原