论文部分内容阅读
宫颈癌根治术,术中副损伤并不多见。本文就我院自1990～1996年宫颈癌根治术504例中,损伤脏器15例,对其损伤情况进行分析如下。 1.临床资料 一般资料 行宫颈癌根治术504例,术中损伤脏器15例,其中输尿管损伤8例,膀胱损伤1例,血管损伤4例,闭孔神经、直肠损伤各1例。年龄55～65岁。临床分期:Ⅰ期9例(60％),Ⅱ期6例(40％)。除4例为腺癌,其余均为鳞状上皮癌。 损伤部位及原因 输尿管损伤:输尿管跨过卵巢动静脉处2例,输尿管膀胱结合部3例,以上5例由于粘连,分离时出血后手术野模糊,解剖层次不清,而误夹、误缝和误切;2例由于过多剥离输尿管鞘膜,营养支破坏过多,引起缺血性坏死后形成尿瘘;1例在处理骶韧带时
Cervical cancer radical surgery, secondary injury and rare. This article from our hospital from 1990 to 1996, radical resection of cervical cancer in 504 cases, 15 cases of organ damage, the damage is analyzed as follows. 1. Clinical data General information of cervical cancer radical operation of 504 cases, 15 cases of intraoperative injury organs, including ureteral injury in 8 cases, 1 case of bladder injury, vascular injury in 4 cases, obturator nerve, rectum injury in 1 case. Age 55 ~ 65 years old. Clinical stage: stage Ⅰ in 9 cases (60%), stage Ⅱ 6 cases (40%). In addition to 4 cases of adenocarcinoma, the rest are squamous cell carcinoma. The injury site and causes of ureteral injury: ureter across the ovarian artery and vein in 2 cases, 3 cases of ureter and bladder junction, more than 5 cases due to adhesion, separation of the hemorrhage after surgery field fuzzy, unclear anatomy, and error folder, Misdiagnosis; 2 cases due to excessive stripping of the ureteral sheath, excessive destruction of the nutritional branch, resulting in formation of fistula after ischemic necrosis; 1 case in the treatment of the sacral ligament