国际妇产科学杂志

国际妇产科学杂志 ›› 2020, Vol. 47 ›› Issue (3): 315-317.

• 论著 • 上一篇    下一篇

腹腔镜下全子宫切除术后膀胱阴道瘘临床分析

夏伟豪，周伟，陈文静，周毅惠   

  1. 241001  安徽省芜湖市，皖南医学院（夏伟豪）；皖南医学院附属弋矶山医院妇产科（周伟，陈文静，周毅惠）
  • 收稿日期:2019-11-21 修回日期:2020-03-15 出版日期:2020-06-15 发布日期:2020-06-23

Clinical Analysis of 6 Cases of Vesicovaginal Fistula after Laparoscopic Hysterectomy

XIA Wei-hao, ZHOU Wei, CHEN Wen-jing, ZHOU Yi-hui   

  1. Wannan Medical College, Wuhu 241001, Anhui Province, China（XIA Wei-hao）；Department of Obstetrics and Gynecology, Yijishan Hospital of Wannan Medical College, Wuhu 241001, Anhui Province, China（ZHOU Wei, CHEN Wen-jing, ZHOU Yi-hui）
  • Received:2019-11-21 Revised:2020-03-15 Published:2020-06-15 Online:2020-06-23

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摘要： 目的：探讨腹腔镜全子宫切除术后膀胱阴道瘘（vesicovaginal fistula，VVF）的病因、手术时机、手术方法及预防措施。方法：回顾性分析 2015年 1 月—2018 年 12 月在皖南医学院附属弋矶山医院因子宫肌瘤或子宫腺肌病行腹腔镜全子宫切除术后发生膀胱阴道瘘的患者6例，年龄39～52岁，全子宫切除术后6 d～1个月。患者经确诊后行膀胱镜、腹腔镜检查，术中修补膀胱瘘。结果：6例修复手术中，1例经腹腔镜完成，1例经阴道完成，3例开腹完成，1例经腹腔镜下修补后转开腹，均手术成功，愈合良好。术后回访未再出现漏尿。结论：解剖层次不清和手术操作不当，是并发膀胱阴道瘘的主要原因。术后一经发现，可行手术修复或待瘘口周围组织愈合后再行手术修复，效果满意。

关键词: 腹腔镜；, 子宫切除术；, 膀胱阴道瘘；, 诊断；, 随访

Abstract: Objective: To explore the prevention and treatment of vesicovaginal fistula (VVF) after laparoscopic hysterectomy. Methods: 6 cases of VVF after laparoscopic hysterectomy for hysteromyoma or adenomyosis in the Yijishan Hospital of Wannan Medical College from January 2015 to December 2018 were retrospectively analyzed, age 39-52 years old, 6 days to 1 month after hysterectomy. The patients underwent cystoscopy and laparoscopy after diagnosis, and the bladder fistula was repaired during operation. Results: Of the 6 repair operations, 1 was completed by laparoscope, 1 by vagina, 3 by direct laparotomy, and 1 by laparoscopic repair and then convert to laparotomy. All operations were successful and healed well. No urine leakage occured during postoperative follow-up. Conclusions: Unclear anatomical level and improper operation are the main causes of VVF. Once discovered after the operation, it can be directly repaired or repaired after tissue healing, with satisfactory results.

Key words: Laparoscopic；, Hysterectomy；, Vesicovaginal fistula；, Diagnosis；, Follow-up