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目的:分析腹腔镜子宫切除术后输尿管阴道瘘的原因,探讨处理方法。方法:选择因腹腔镜子宫切除术所致输尿管阴道瘘患者26例的资料进行回顾性分析。结果:26例中,11例为电刀电凝伤,7例为血液运输障碍,手术直接损伤、输尿管缝扎引起各3例,解剖变形引起2例。18例行输尿管膀胱再吻合术者16例治愈,2例复发,给予皮肾穿刺造瘘术+膀胱瓣输尿管吻合术治疗后治愈。6例行输尿管镜下留置双J管者5例治愈,1例再次手术后治愈。2例给予膀胱镜内置双J管者均治愈。结论:腹腔镜子宫切除术后输尿管阴道瘘的原因复杂,应根据具体情况制定针对性的治疗措施,治疗以恢复正常排尿通路、保护肾脏功能为原则。
Objective: To analyze the causes of ureteropelvic fistula after laparoscopic hysterectomy and to discuss the treatment methods. Methods: The data of 26 patients with ureteric fistula due to laparoscopic hysterectomy were retrospectively analyzed. Results: Among the 26 cases, 11 cases were electric coagulation injury, 7 cases were blood transportation disorder, direct operation injury, ureteral suture caused 3 cases each and anatomical deformation caused 2 cases. 18 cases of ureteral re-anastomosis were cured in 16 cases, 2 cases of recurrence, give the skin nephroureterectomy + bladder anastomosis cured. 6 cases underwent ureteral dilatation of double J tube were cured in 5 cases, and 1 case was cured again after operation. 2 cases were given cystoscopy double J tube were cured. Conclusions: The causes of ureteropelvic fistula after laparoscopic hysterectomy are complicated. Specific treatment measures should be made according to the specific conditions. The treatment should be based on the principle of restoring normal urination pathways and protecting renal function.