IMPORTANCE DE LA CISTOSCOPIA PARA ASEGURAR LA INDEMNIDAD DE LOS URÉTERES DESPUÉS DE CIRUGÍA VAGINAL.

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    • Abstract:
      Objective: To determine the frequency of ureteral obstruction like complication of the vaginal hysterectomy (VH) or laparoscopic attended vaginal hysterectomy (LAVH) with McCall's culdoplasty. To determine the feasibility, security and effectiveness of the indigo carmine test observed by routine intraoperative cistoscopy to identify the ureteral indemnity. Method: Prospective study of 56 patients submissive VH or LAVH with McCall's culdoplasty between January 2003 and May 2006, in the Unit of Gynecology of the Department of Gynecology and Obstetrics of Clinica Las Condes. The median age was 48 years old (rank: 38 to 74), BMI 25 (rank: 21 to 34), parity 2 (rank: 0 to 3). Positive test of ureteral indemnity was defined as the exit of blue coloration by both ureteral meatus. Results: Only 1 (1.8%) of the 56 patients registered a ureteral obstruction (right ureter). The McCall sutures were replaced being stated the second indigo carmine test positive verifying ureteral indemnity. Conclusions: The indigo carmine test observed by cistoscopy is a feasible, safe and effective method to determine the ureteral indemnity. In all those gynecological surgeries with a high risk of ureteral obstruction, the intraoperative cistoscopy with negative indigo carmine test allows a fast and easy solution during the same operating time, avoiding a possible kidney loss. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Objetivos: Determinar a frecuencia de obstrucción ureteral como complicación de Ia histerectomia vaginal (HV) o laparoscópica asistida vaginal (HLAV) con culdoplastía de McCall. Evaluar a factibilidad, seguridad y eficacia de a prueba con índigo carmín y de Ia cistoscopia intraoperatoria de rutina, para deterrninar Ia indemnidad ureteral. Método: Estudio prospectivo de 56 pacientes sometidas a HV o HLAV con culdoplastía de McCall, entre enero de 2003 y mayo de 2006, en Ia Unidad de Ginecología del Departamento de Ginecología y Obstetricia de Clinica Las Corides. La media de edad fue 48 años (rango: 38 a 74), IMC 25 (rango: 21 a 34), paridad 2 (rango: 0 a 3 partos). Se consideró prueba positiva de indemnidad ureteral a Ia salida del colorante a vejiga por ambos meatos. Resultados: Sólo 1 (1,8%) de las 56 pacientes registró una obstrucción ureteral (ureter derecho). Se reposicionaron los puntos constatán- dose a segunda prueba con índigo carmín positiva, verificando indemnidad ureteral. Conclusión: La prueba de índigo carmín con visualización cistoscópica intraoperatoria, es un método factible, seguro y eficaz, para determinar Ia indemnidad ureteral. En todas aquellas cirugías ginecológicas con alto riesgo de obstrucción ureteral, Ia cistoscopia intraoperatoria con prueba de índigo carmín negativa, permite realizar una solución rápida y fácil durante el mismo tiempo operatorio, evitando una posible pérdida renal. [ABSTRACT FROM AUTHOR]
    • Abstract:
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