{"created":"2023-06-20T15:48:51.143345+00:00","id":3381,"links":{},"metadata":{"_buckets":{"deposit":"475d8f06-11a5-4a93-9637-63099800645c"},"_deposit":{"created_by":4,"id":"3381","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"3381"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00003381","sets":["1:12:68"]},"author_link":["9915","9916","9917","9918","9919","9920"],"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"73","bibliographicPageStart":"69","bibliographicVolumeNumber":"8","bibliographic_titles":[{"bibliographic_title":"静岡産科婦人科学会雑誌","bibliographic_titleLang":"ja"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"腹腔鏡下子宮全摘術（total laparoscopic hysterectomy; 以下TLH）は開腹手術よりも術後回復が早く、子宮筋腫などの良性疾患では広く行われている。TLHの合併症の一つに尿管損傷がある。今回、TLH術後7日目に遅発性水腎症が判明し、経過観察にて改善した一例を経験したので報告する。症例は47歳、BMI35.7。子宮筋腫による過多月経、貧血があり、TLHを施行した。術後7日目に左下腹部、背部痛のため外来受診した。左水腎症を認め、尿管ステント留置を試みたが、膀胱から尿管口に入ってすぐの部位からガイドワイヤーが進まなかった。腎瘻を作成できる程の水腎症ではなく、経過観察とした。術後1ヶ月にて水腎症は消失し、腎機能は改善した。手術ビデオの検討では、膀胱剥離時に止血した際のバイポーラーによる影響が尿管および尿管周囲組織に及んだ可能性が考えられた。術後に遅発性水腎症が判明した場合、症状や感染徴候、腎機能障害の程度によっては自然経過観察のみで改善する場合もある。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"Compared to laparotomy, postoperative recovery is faster with total laparoscopic hysterectomy (TLH), which is widely performed for benign diseases such as uterine myoma. Ureteral injury is one of the complications of TLH. In this report, we describe a case of delayed hydronephrosis that became evident on the 7th postoperative day which improved on observation over the follow-up period.A 47-year-old patient with a BMI of 35.7 kg/m2 had a history of menorrhagia and anemia due to a uterine myoma, for which a TLH was performed. On postoperative day 7, the patient complained of pain in the lower abdomen and back. On examination in the outpatient department, left-sided hydronephrosis was observed and an attempt was made to insert a ureteral stent. However once the stent entered the ureteric orifice from bladder, the guidewire could not be advanced further from the site. In this case of hydronephrosis, a nephrostomy could not be created; therefore, follow-up observation was the treatment policy. One month postoperatively, the hydronephrosis had disappeared and renal function had improved. Examination of the surgical video revealed that the effect of the bipolar cautery at the time of hemostasis when the bladder was being detached likely impacted the ureter and the tissues surrounding the ureter. If delayed hydronephrosis becomes evident after surgery, depending on the symptoms, signs of infection, and extent of renal function impairment, improvement may be noted with follow-up observation only.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"静岡産科婦人科学会","subitem_publisher_language":"ja"}]},"item_3_source_id_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"21871914","subitem_source_identifier_type":"ISSN"}]},"item_3_version_type_32":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"鎌田, 麻由美","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小山内, 久人","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"橋本, 裕子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"橋本, 正広","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"立岡, 和弘","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"岩崎, 真也","creatorNameLang":"ja"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-03-26"}],"displaytype":"detail","filename":"jsog_8_1_69.pdf","filesize":[{"value":"447.7 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsog_8_1_69","url":"https://hama-med.repo.nii.ac.jp/record/3381/files/jsog_8_1_69.pdf"},"version_id":"9638ad62-d961-444f-b9df-9a4327797ac0"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"TLH","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"hydronephrosis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"ureteral injury","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"腹腔鏡下子宮全摘術による遅発性水腎症において尿管ステントが挿入できず経過観察にて改善した一例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"腹腔鏡下子宮全摘術による遅発性水腎症において尿管ステントが挿入できず経過観察にて改善した一例","subitem_title_language":"ja"},{"subitem_title":"Follow-up observation in delayed hydronephrosis following total laparoscopic hysterectomy for which a ureteral stent could not be inserted: a case report","subitem_title_language":"en"}]},"item_type_id":"3","owner":"4","path":["68"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2019-03-26"},"publish_date":"2019-03-26","publish_status":"0","recid":"3381","relation_version_is_last":true,"title":["腹腔鏡下子宮全摘術による遅発性水腎症において尿管ステントが挿入できず経過観察にて改善した一例"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-08-01T06:55:52.777121+00:00"}