改进式乙状结肠直肠膀胱术

目的　对改进的乙状结肠直肠手术临床疗效给于评价。方法　对 19例膀胱肿瘤采用改进式乙状结肠直肠膀胱成形手术 ,在原手术的基础上于乙状结肠直肠开口与低压肠袋进入直肠的交界处上方做双重荷包缝合 ,缩小低压肠袋进入直肠的开口 ,防止粪便返流逆行感染的发生。结果　 19例术后尿控均良好 ,无高氯性酸中毒 ,上尿路检查无梗阻、积水、输尿管扩张现象 ,成形膀胱容量 40 0～ 6 0 0ml,排尿后残余尿量为 0～ 6 0ml。结论　本术式对肠道干扰小 ,操作比较简单 ,手术后尿控理想 ,上尿路并发症少 ,明显提高了患者的生活质量。

A modified technique of reconstruction of bladder with sigmoid

Objective To evaluate the clinical efficacy of a modified technique of reconstruction of bladder with sigmoid.Method The reconstruction of bladder with sigmoid was modified for treatment of 19 cases of bladder tumor. On the basis of original operation, the double purse-string suture was performed on the sigmoid-rectal open and upper of entrance rectum of hypobaric colonic bag. The entrance was reduced to prevent the infection from reflux of stool.Results Among 19 patients with this operation, the controlled emiction were good, and hyperchloremic acidosis, obstruction, hydropsy and dilation of ureter didn't occurred. The volume of reconstructive bladder was 400～600*!ml and the residual urine volume was 0～60*!ml. Conclusion This operative method possesses some advantages such as little complications and interfere to entestine,well emiction control, and higher quality of life for patients.