The Complication of Ureteral Injury Induced by Gynecological Laparoscopic Surgery

Z. Dong, Mengyue Chen, Junling Liu, Zhenyue Qin, Huihui Wang, M-W Bao, Ruxia Shi, Jiming Chen
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Abstract

: Compared with traditional laparotomy, laparoscopic surgery has obvious advantages (smaller incisions, shorter hospital stays, and reduced blood loss). At present, more and more gynecological surgeries can be completed under laparoscopy. With the increasement of clinical treatment of gynecological laparoscopic surgery, the complications related to gynecological laparoscopic surgery and their prevention measures have become a continuous concern in the field of gynecology. T he risk of injury to the lower urinary tract, consisting of the bladder and ureters, is inherent to gynecologic surgery regardless of operative technique, because the bladder and ureters lie adjacent to other critical structures. Ureteral injury caused by gynecological laparoscopic surgery is a relatively rare complication. Clinicians do not pay enough attention to it because of its low incidence. However, once it happens, the consequences are often serious. The clinical manifestations of ureteral injury caused by gynecological laparoscopic surgery vary greatly according to the location and severity of the injury. Patients with mild injury can heal themselves after conservative treatment, and patients with severe injury can have serious consequences such as peritonitis and acute renal insufficiency, and even lead to death. This paper will focus on ureteral anatomy, common causes, clinical manifestations, key points of diagnosis, treatment measures and prevention strategies of ureteral injury caused by laparoscopic surgery.
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妇科腹腔镜手术输尿管损伤的并发症分析
:与传统剖腹手术相比,腹腔镜手术优势明显(切口小、住院时间短、出血量少)。目前,越来越多的妇科手术可以在腹腔镜下完成。随着妇科腹腔镜手术临床治疗的增多,与妇科腹腔镜手术相关的并发症及其预防措施已成为妇科领域持续关注的问题。下尿路由膀胱和输尿管组成,无论采用何种手术技术,下尿路损伤的风险都是妇科手术固有的,因为膀胱和输尿管毗邻其他关键结构。妇科腹腔镜手术引起输尿管损伤是一种比较少见的并发症。由于发病率低,临床医生对其重视不够。然而,一旦发生,后果往往是严重的。妇科腹腔镜手术输尿管损伤的临床表现根据损伤部位和严重程度的不同有很大差异。轻伤患者经保守治疗可自愈,重伤患者可出现腹膜炎、急性肾功能不全等严重后果,甚至导致死亡。本文将重点介绍腹腔镜手术输尿管损伤的输尿管解剖、常见原因、临床表现、诊断要点、治疗措施及预防策略。
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