علاج إصابة الحالب المعرفة فوراً أثناء العملية في مريض مستقر ديناميكياً دموياً

References

• Repair iatrogenic ureteral injuries recognised during surgery immediately.
• In cases of unstable trauma patients, a 'damage control' approach is preferred with ligation of the ureter, diversion of the urine (e.g. via a nephrostomy), and a later delayed definitive repair.
• A ligation injury during an operation can be managed by de-ligation and stent placement.
• Partial injuries can be repaired immediately with a stent or urinary diversion via a nephrostomy tube.
• Immediate repair of complete ureteral injury is advisable as it significantly decreases the need for secondary or tertiary procedures compared to delayed repair.
• The ureter is mobilised on both ends and a spatulated end-to-end anastomosis is performed.
• Primary repair by uretero-ureterostomy or ureteric re-implantation can be safely performed laparoscopically at the time of the iatrogenic injury, with good medium-term results.