膀胱全切低压回肠代膀胱术的技术改进

为探讨低压回代膀胱术的技术改进及远期疗效,对16例全膀胱切除的膀胱患者施行回肠袋近端肠管人工套叠加隧道式输尿管肠吻合术,同时用2％碘酊处理回肠袋粘膜,以减少肠粘膜分泌与吸收。结果显示,手术时间平均5小时50分钟,无手术死亡。术后随访11－72个月,全部患者白天均能自控排尿,无输尿管返流、代谢性酸中毒、无再次手术者。表明本术式具有成功率高,并发症少,患者术后生活质量高等优点。

Improving and curative effect of total cystectomy and ieal replacement of bladder

To stuty the improving and long term curative effect of ileal replacement of bladder in situ and low pressure,16 cases of cystic carcinoma were operated by artificial intussuception of proximal ileal pouch plus tunnel ureteroileostomy after total cystectomy,the mucosa of ileal pouch was dealed with 2% tincture of iodine to reduce the secretion and absorption. Results showed that the mean operative time was 5 hours and 50 minutes. No cases were die. Following up for 11 72 months, all cases were of urinating continence in days, free of ureteral refloux and metabolic acidosis, no cases were operated again. It suggests that the method had the advantage of high success rate, less complication and high postoperative living quality.