阑尾原位经脐造口可控性回盲肠膀胱术

目的探讨阑尾原位直接经脐造口可控性尿流改道的临床疗效。方法回顾性分析31例接受了阑尾原位经脐造口可控性尿流改道术患者的临床资料，术中采取一简单有效的测压方法来判断阑尾盲肠连接处的控尿能力。术后随访2—60个月，平均15个月。结果31例患者中26例（83．87％）获得了完全的控尿能力，无围手术期死亡和严重手术并发症，5例患者术后出现经脐插管困难，经门诊扩张无须手术修复而治愈。术中及术后测压表明，阑尾盲肠交界处在储尿囊压力达到40cmH2O时均无漏尿。结论在一个大容量、低压力储尿囊中，阑尾原位无须隧道包埋或套叠即可获得满意的控尿能力。

Continent urinary diversion with an unaltered in situ appendix as an appendicoumbilical stoma

Objective To explore the efficiency of using the unaltered in situ appendix as an appendicoumbilical stoma.Methods 31 patients were undergone continent urinary diversion using in situ without any reinforce appendicoumbilical stoma.Intraoperative ceco-appendiceal junction was assessed for continence using a simple available measure.Patients were followed at the urological clinic for an average of 15 months(range2-60 months).Results 26 of these 31 patients were completely controlled urine for day and night.There were no operative mortalities or major perioperative complications.Five of these patients developed postoperative difficulty with self-catherization and stomal dilations were successfully treated without reoperation.Intraoperatively measured in situ pressure profiles of the cecoappendiceal junction was demonstrated that the junction remains competent at 40 cmH2O at least.Conclusion In a low pressure,large capacity reservoir continence may be achieved simply by placed the appendix in situ without any reinforce.