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タイトル: 医原性尿路損傷に対する尿路修復術の検討
その他のタイトル: Iatrogenic Injuries of Urinary Tract : Outcomes of Surgical Repairs
著者: 松村, 善昭  KAKEN_name
家村, 友輔  KAKEN_name
福井, 真二  KAKEN_name
影林, 賴明  KAKEN_name
三馬, 省二  KAKEN_name
著者名の別形: Matsumura, Yoshiaki
Iemura, Yusuke
Fukui, Shinji
Kagebayashi, Yoriaki
Samma, Shoji
キーワード: Urinary tract
Injuries
Surgical repair
発行日: 31-Mar-2018
出版者: 泌尿器科紀要刊行会
誌名: 泌尿器科紀要 = Acta urologica Japonica
巻: 64
号: 3
開始ページ: 95
終了ページ: 99
抄録: Iatrogenic urinary tract injuries are known complications of digestive and pelvic surgeries. We retrospectively reviewed 13 patients with bladder injuries and 16 patients with ureteral injuries requiring surgical repair or stent placement in our hospital between 2013 and 2016. Obstetric-gynecologic surgery accounted for 10 bladder injuries and 11 ureteral injuries on hysterectomy and Cesarean section. Digestive surgery led to 1 bladder injury and 5 ureteral injuries on colon resection, and urologic surgery resulted in 1 injury on biopsy of a retroperitoneal tumor. Regarding bladder injuries, 10 patients underwent cystorrhaphy, and 3 patients received indwelling of a transurethral Foley catheter alone. Concerning ureteral injuries, 7 patients underwent repair of the injured ureter (ureteroneocystostomy in 5, and ureteroureterostomy in 2), and 9 patients received ureteral stent placement after postoperative retrograde urography. Repair failure was defined when urine leakage, urinary fistula, or urinary stricture requiring ureteral stent placement still existed at 90 days after the repair treatment. The bladder injuries in all 13 cases were successfully repaired. The ureteral injury treatments in 7 out of 16 patients (43.8%) were judged as being unsuccessful because of the condition requiring a ureteral stent at 90 days. There was a correlation between the delayed diagnosis of ureteral injury and unsuccessful repair. The present study showed that the prompt identification of urinary tract injuries, especially ureteral injuries, can result in decreased morbidity andsubsequently improved outcomes.
著作権等: 許諾条件により本文は2019/04/01に公開
DOI: 10.14989/ActaUrolJap_64_3_95
URI: http://hdl.handle.net/2433/230898
PubMed ID: 29684957
出現コレクション:Vol.64 No.3

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