摘要
目的:描述一种改良的经阴膀胱阴道瘘修补术并报告其初步临床应用结果。方法:在经阴膀胱阴道瘘修补术中,采用Foley导尿管牵引技术为手术提供良好的视野暴露,同时为组织层次的分离提供有效的对抗牵引力量和可靠的依托平台,使手术程序简化,难度降低,提高组织分离的准确性,减少组织切除量,完成瘘口的三层无张力关闭。本组共有12例膀胱阴道瘘患者接受改良的经阴膀胱阴道瘘修补术,其中三角区上方瘘9例,三角区瘘3例,5例曾经历过一次以上失败的修补术。结果:12例患者均一次手术成功,手术时间20～80min,出血量均<100ml,住院时间5～14d,留置导尿管时间13～23d。随访3～36个月,未发现瘘复发,3例有泌尿系感染经抗菌素治愈,1例表现出压力性尿失禁经做中段尿道吊带术治愈。结论:以Foley导尿管牵引技术为特点的改良经阴膀胱阴道瘘修补术是一种创伤小,成功率高的手术方式。
Objective：To describe a modified technique of.transvaginal repair of vesicovaginal fistula and report the primary outcomes. Method：A Foley catheter was inserted into bladder through the fistula at the beginning of the procedure. With the Foley catheter flatted and retracted outwards, the fistulous site was moved down and good exposure of the operating field achieved. This retracted catheter and flatted balloon provide good base for the dissection and separation of tissue layer of vaginal wall, bladder wall and bladder mucus. This technique facilitates the procedure and permits tensionless closure of tissue in 3 layers. Totally 12 patients with vesicovaginal fistula （9 with supratrigonal fistula and 3 trigonal, 5 experiencing one or more failure repair） were operated on with this modified transvaginal repair. Result：All 12 cases of patients were successfully repaired at one attempt, operating time 20-80 minutes, blood loss less than 100 ml, hospital time 5-14 days, cathetering time 13-23 days. During the follow up of 3-36 monthes, no recurrence of fistula occurred, and 3 patients experiencing urinary tract infection were cured with antibiotics, 1 patients presenting with stress urinary incontinence were cured with mid urethral sling. Conclusion：The present modified transvaginal repair technique featured with Foley catheter retraction proved to be a mini invasive, simple and reliable surgical procedure for the repair of vesicovaginal fistula.
出处
《临床泌尿外科杂志》
2013年第3期215-217,共3页
Journal of Clinical Urology
