摘要
目的 :探讨正位可控性去带盲结肠膀胱术的临床疗效。方法 :对 1 7例膀胱肿瘤患者行膀胱全切除术后 ,应用末段回肠及盲升结肠作贮尿囊行正位膀胱重建术。结果 :1 7例中 1 5例获随访 6～ 2 4个月 ,平均 1 4 .5个月。全组无严重并发症 ,均无瘤生存 ;术后 3周自主可控性排尿 ,日间排尿可控率为 93.3% ,1年夜间尿失禁2 2 .2 %。术后 6个月尿动力学检查 ,膀胱容量 336ml、最大尿流率 1 3.7ml/s、剩余尿量 4 2ml,而充盈期膀胱压力明显低于尿道闭合压。输尿管反流 1例 ,但无尿道、输尿管狭窄 ,肾功能正常。结论 :正位可控性去带盲结肠膀胱术具有膀胱容量大、内压低 ,正位排尿 ,可控性好 ,且手术操作简单、并发症少等优点 ,患者易于接受 。
Purpose:To evaluate the orthotopic detinia cecal ascending colon continent urinary reservoir after radical cystectomy for the management of bladder cancer. Methods:Seventeen cases of bladder cancer managed by the orthotopic detinia cecal ascending colon continent urinary reservoir after radical cystectomy were reviewed and evaluated. Results:Fifteen in 17 patients have been followed up for 6～24 months with a mean of 14.5 months. No serious operative complications occurred. The daytime urinary continence rate was 93.3 % and the nocturnal incontinence rate 22.2 %. Urodynamics was carried out at 6 months after operation. It showed that the average capacity of the urinary reservoir, the peak urinary flow rate and residual urine volume were 336 ml, 13.7 ml/s and 42 ml respectively. But the intrareservoir pressure was significantly lower than the intraurethra pressure. Ureteral reflux occurred in 1 patients, but no evidence of urethral stricture, ureteral stricture and no hyperchloremic acidosis was observed. Conclusions:Orthotopic detinia cecal-ascending colon continent urinary reservoir might be an ideal form of urinary diversion, which was characterized by low pressure, large capacity, orthotopic continent urination and simple and easy techniques.
出处
《临床泌尿外科杂志》
2003年第11期648-649,652,共3页
Journal of Clinical Urology
关键词
膀胱肿瘤
膀胱切除术
尿流改道
Bladder neoplasms
Cystectomy
Urinary diversion
