Application experience of two double J tubes in the treatment of ureteral thermal damage after gynecological laparoscopic surgery

Objective: To investigate the safe,effective and minimally invasive treatment of late diagnosed thermal damage of ureter caused by gynecological laparoscopy. Methods: The clinical data of 4 cases of ureteral injury were retrospectively analyzed. 2 cases of adenomyosis,1 case of cervical cancer and 1 case of ovarian endometriosis cyst were included. Laparoscopic panhysterectomy,laparoscopic radical operation for cervical cancer and laparoscopic ovariocystectomy were performed respectively. Thermal ureteral injury was diagnosed in the 8 th,8 th,16 th and 10 th day respectively. Injury was found 1-10 cm above the ureteral opening through ureteroscope. Local appearance was pale and ulcer. Fracture plane of the ureter accounted for 1 /3-2 /3. Results: Two patients in the 4 cases succeeded in placing two DJ tubes after failure of placing one tube. The other two patients succeeded in placing two DJ tubes directly. Four patients were extubated after 3 months. The longest follow-up visit lasted for more than 2 years and no abnormality was found. Conclusions: Laparoscopic gynecological surgery can lead to the thermal damage of ureter,which is usually found lingeringly. The stent and drainage of two DJ tubes is more effective and not easy to be blocked,which will be effective in preventing the long-term scar stricture and avoiding reoperation. So it is an effective way of conservative treatment.