URETERAL INJURY DURING GYNECOLOGICAL LAPAROSCOPIC SURGERIES: REPORT OF TWELVE CASES

作     者：Jin-song Gao Jin-hua Leng Zhu-feng Liu Keng Shen Jing-he Lang 

作者机构：Department of Obstetrics and Gynecology Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 

出 版 物：《Chinese Medical Sciences Journal》 (中国医学科学杂志（英文版）)

年 卷 期：2007年第22卷第1期

页      面：13-16页

核心收录：

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主　　题：ureteral injury laparoscopy iatrogenic complication 

摘      要：Objective To investigate ureteral injury during gynecological laparoscopic *** From January 1990 to December 2005, 12868 gynecological laparoscopic surgeries were conducted in Peking Union Medical College Hospital with 12 ureteral injuries reported. The present study investigated several aspects, including surgical indications, uterine size, pelvic adhesion, operative procedures, symptoms, diagnostic time and methods, injury site and type, subsequent treatment, and prognosis. Results The incidence of ureteral injury was 0.093% (12/12868) in all cases, 0.42% (11/2586) in laparoscopic hysterectomy [laparoscopically assisted vaginal hysterectomy (LAVH) or total laparoscopic hysterectomy (TLH)], and 0.01% (1/10282) in non-LAVH surgeries. Enlarged uterus, pelvic adhesion, and endometrosis were risk factors associated with ureteral injury. Only one injury was found intraoperatively while others were found postoperatively. The injury sites were at the pelvic brim (2 cases) or the lower part of ureter (10 cases). Patients were treated with ureteral stenting (effective in 2 cases) or laparotomy and open repair. Prognoses were favorable in most cases. Conclusions Most laparoscopic ureteral injuries occur during laparoscopic hysterectomy. Further evaluation is required when ureteral injury is suspected, and surgical repair is the major treatment for ureteral injury.