经尿道输尿管镜联合钬激光治疗缝扎性下段输尿管损伤8例
摘要
目的探讨经尿道输尿管镜联合钬激光治疗缝扎性下段输尿管损伤的疗效。方法收集行妇产科盆腔手术后发生缝扎性下段输尿管损伤的8例女性患者的临床资料。8例患者妇产科盆腔手术后1周内因腰痛、腰胀症状发现输尿管异常,采用经尿道输尿管镜联合钬激光治疗,并分析其治疗效果。结果 8例患者术中输尿管镜下均成功找到结扎缝线,采用钬激光将缝线击断松解;输尿管镜顺利进至输尿管近端,发现输尿管黏膜较为完整、损伤较小,均予以留置2根双J管。术后3个月拔除2根双J管,患者腰痛、腰胀症状消失。术后6个月时静脉肾盂造影(IVU)检查提示患侧尿路连续性恢复,输尿管通畅,无输尿管狭窄,肾盂输尿管积水消失。结论经尿道输尿管镜联合钬激光治疗缝扎性下段输尿管损伤具有微创、高效、并发症少、易被患者接受等优点。
引文
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[3]Koukouras D,Petsas T,Liatsikos E,et al.Percutaneous minimally invasive management of iatrogenic ureteral injuries[J].J Endourol,2010,24(12):1921-1927.
[4]Toproff B,Scalea TM,Abramson D,et al.Ureteral laceration caused by a fall from a height:case report and review of the literature[J].Trauma,2009,34(3):164.
[5]Gao JS,Leng JH,Liu Z F,et al.Ureteral injury during gynecological laparoscopic sureries:report of twelve cases[J].2007,22(1):13-16.
[6]Modi P,Goel R,Dodiya S.Laparoscropic ureteroncystostomy for diatal ureteral injuries[J].Urology,2005,66(4):751-753.
[7]Gnessin E,Yossepowitch O,Holland R,et al.Holmium laser endoureterotomy for benign ureteral stricture:a single center experience[J].J Urolog,2009,182(6):2775-2779.