子宮頸癌根治手術症例における下部尿管の機能 : 子宮動脈尿管枝保存法の効果

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How to protect the ureteral function is one of the most important problems in radical operation of uterine cervix cancer. The influence of every steps of operative procedures in the OKABAYASHI operation on the function of the ureter has been electrophysiologically studied in the author's previous investigations and it has been proved that the stasis of blood supply to paravesical segment of the ureter by ligation of uterine artery and resection of cardinal ligament causes hypofunction of the ureter. Therefore, an attempt was made to preserve the circulation of paravesical segment of the ureter by preparating artery from the junction of hypogastric artery to the level at which it crosses with ureter and cutting at just peripherally of the branching part of ramus uretericus. Thus, the ramus uretericus is kept preservative. To examine the post operative ureteral function, renogram, D.I.P., and the pressure tracing of ureteral peristalsis in the paravesical segment were recorded at 20 days after opration and were compared with those in control group operated by original procedure of the OKABASHI operation. The incidence of normal renogram was 21.1% in the control groud but was 46.0% in the cases with preserved ramus uretericus. Regarding D.I.P. whereas 50% of cases showed hydronephrosis in the control group, only 37.5% of study group showed a mild degree of hydronephrosis. On the pressure tracing of ureteral peristalsis, the hypoperistalsis of grade IV in which peristalsis is never recorded over 20 minutes is observed in 40% of the control group, but such hypoperistalsis was not observed in any case of study group. It was concluded that such a modification is very effective to preserve the ureteral function.
神戸大学の論文

子宮頸癌根治手術症例における下部尿管の機能 : 子宮動脈尿管枝保存法の効果

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