全膀胱切除回肠膀胱术15年总结(附196例报告)

目的　评价全膀胱切除治疗膀胱肿瘤的疗效及回肠膀胱术的远期效果。　方法　回顾性分析 1985年 1月至 2 0 0 0年 1月膀胱肿瘤行全膀胱切除回肠膀胱术 196例的临床资料。　结果　膀胱肿瘤累及膀胱颈部或膀胱三角区者 12 6例 (6 4.3 % ) ,浸润性膀胱癌 145例 (74.0 % ) ,移行细胞癌183例 (93.4% )。术后发生近期并发症 19例 (9.7% ) ,远期并发症 10例 (7.4% )。 135例随访 1～ 15年 ,平均 6 .6年 ,5年生存率 6 6 .2 %。　结论　全膀胱切除是浸润性膀胱癌首选治疗方法 ,回肠膀胱术简单易行 ,长期随访显示其并发症少 ,疗效确切 ,仍是一种较为理想的尿流改道方式。

15-year''''s experience on the management of bladder cancer by radical cystectomy and ileal conduit (report of 196 cases)

Objective To evaluate the long term efficacy of radical cystectomy and ileal conduit in the treatment of bladder cancer. Methods 196 cases of bladder tumor treated from Jan. 1985 to Jan. 2000 with radical cystectomy and ileal conduit for urinary diversion were studied retrospectively. Results Bladder neck or trigone was involved by the neogrowth in 126(64.3%).The growth has been invasive in 145(74.0%). 93.4%(183/196) of the tumor were transitional cell carcinoma. Early operative complication occurred in 19(9.7%) and late complication in 10(7.4%).On following up for 1 to 15 years with a mean of 6.6 years,the 5 year survival rate has been 66.2%. Conclusions Radical cystectomy is the optimal in treating invasive bladder tumor and ileal conduit is a good means of urinary diversion which is simple with minimal complications.