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原位肠代膀胱术远期疗效评价(附266例报告)
引用本文:徐鸿毅,邱学德,石永福,李泽惠,李炯明,王剑松,左毅刚,杨德林,陈戬,方克伟,刘靖宇. 原位肠代膀胱术远期疗效评价(附266例报告)[J]. 中华泌尿外科杂志, 2005, 26(8): 551-554
作者姓名:徐鸿毅  邱学德  石永福  李泽惠  李炯明  王剑松  左毅刚  杨德林  陈戬  方克伟  刘靖宇
作者单位:1. 650101,昆明医学院第二附属医院泌尿外科
2. 650101,昆明医学院第二附属医院泌尿肾病中心
3. 650101,昆明医学院第二附属医院微创泌尿外科
摘    要:目的 总结评价原位肠代膀胱术的远期临床效果。方法 对1991-2003年266例因膀胱癌行膀胱全切手术患者资料进行分析。Hautmann回肠原位代膀胱术206例,Reddy原位结肠代膀胱术60例。131例患者在原标准术式基础上作了手术技术改进。总结手术改进前后患者控尿率和并发症发生率等。结果 获完整随访患者225例。回肠代膀胱术改进前后男性平均随访时间62(44-146)个月和38(4-67)个月;结肠原位代膀胱手术改进前后患者平均随访时间为62(51-131)个月和34(5-67)个月。手术改进可提高男性术后夜间可控率(P〈0.05),女性改善不明显(P〉0.05),总的近期和远期并发症发生率为13.8%和19.6%。男性肿瘤尿道复发9例(4%),女性无复发。结论 原位尿流改道术的远期临床疗效满意,并发症发生率低。手术技术改进可提高男性患者的夜间控尿率。

关 键 词:原位肠代膀胱术 疗效评价 膀胱癌 膀胱全切术
收稿时间:2004-08-07
修稿时间:2004-08-07

The evaluate of long-term clinical effects of radical cystectomy with orthotopic ileal and colonic neobladder
XU Hong-yi,QIU Xue-de,LI Ze-hui,SHI Yong-fu,LI Jiong-ming,WANG Jian-song,ZUO Yi-gang,YANG De-lin,CHEN Jian,FANG Ke-wei,LIU Jing-yu. The evaluate of long-term clinical effects of radical cystectomy with orthotopic ileal and colonic neobladder[J]. Chinese Journal of Urology, 2005, 26(8): 551-554
Authors:XU Hong-yi  QIU Xue-de  LI Ze-hui  SHI Yong-fu  LI Jiong-ming  WANG Jian-song  ZUO Yi-gang  YANG De-lin  CHEN Jian  FANG Ke-wei  LIU Jing-yu
Abstract:Objective To evaluate the long-term clinical effects of orthotopic ileal and colonic neobladder. Methods The clinical data of 266 cases of bladder carcinoma who underwent radical cystectomy from 1991 to 2003 were summarized and analyzed.Among them, Hautmann orthotopic ileal neobladder was performed in 206 cases and Reddy orthotopic colonic neobladder was performed in 60 cases.Of the 266 cases,131 were treated by improved techniques based on original standard procedure after July 1999.The continence and complications before and after the improvement of the surgical procedures were followed up. Results Complete follow-up was performed in 225 cases.The mean follow-up before and after the improvement of orthotopic ileal neobladder was 62 (44-146) and 38 (4-67) months,respectively.The mean follow-up before and after the improvement of orthotopic colonic neobladder was 61 (51-131) and 34 (5-67) months,respectively.The improved procedure increased nocturnal continence rate in men (P<0.05), but not significantly in women (P>0.05).The overall short-term and long-term complication rates were 13.8% and 19.6%,respectively.The recurrences of urethral tumors in males and females were 4% (9 cases) and 0,respectively. Conclusions The long-term clinical effects of orthotopic ileal and colonic neobladder were satisfactory with low complication rate.The improved procedure can increase the rate of nocturnal continence in male patients.
Keywords:Bladder neoplasms   Carcinoma   Orthotopic urinary diversion
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