宫颈癌放疗后膀胱阴道瘘10例临床分析

摘要

Objective To explore the treatment on vesieovaginal fistula (VVF) after radiotherapy of uterine cervix cancer. Methods Ten cases of VVF after radiotherapy of uterine cervix cancer were analyzed retrospectively. All patients were diagnosed by eystoscope and methyhhioninium chloride test. Two eases were diagnosed after curetive radiotherapy and other 8 cases after adjuvant radiotherapy. The VVFs were diagnosed at 3～58 months after radiotherapy. Results The VVFs were repaired at 4～ 16 months after diagnosis. 6 cases were successfully repaired, 3 were given urinary diversion (1 case for tumor locally relapse and 2 cases for severe radioactive damage) and 1 ease failed for tumor relapse and locally infiltrate. Conclusions The repair of VVF after radiotherapy of uterine cervix cancer is difficult. The timing of repair and controlling of tumor are important for the operation outcome. Urinary diversion should be considered in patients with severe radioactive damage or local tumor relapse.%目的 探讨宫颈癌放疗后并发膀胱阴道瘘的处理.方法 回顾性分析1995年1月至2009年1月收治的10例官颈癌放疗后并发膀胱阴道瘘患者的临床资料.尿瘘出现于宫颈癌放疗后3～58个月,2例为根治性放疗出现膀胱阴道瘘,另外8例于术后辅助放疗时出现,均经膀胱镜检查和亚甲蓝试验确诊.于尿瘘后4～16个月行手术修补.结果 6例手术修补成功;2例由于放射性损伤严重而行尿流改道,1例先行直接修补后因肿瘤局部复发再次出现膀胱阴道瘘而行尿流改道术;1例由于肿瘤复发而修补失败.结论 官颈癌放疗后出现的膀胱阴道瘘修补难度大,修补时间及肿瘤控制情况影响修补成功率;部分放射性损伤严重或有局部肿瘤复发的患者可以考虑行尿流改道手术.