保留性神经的膀胱全切除原位回肠膀胱术34例临床分析

目的研究保留性神经的膀胱全切除原位回肠膀胱术在年轻膀胱癌患者中的临床疗效,为临床诊治提供依据.方法选取1998年 l 月至2010年6月我院诊治的年轻膀胱癌患者34例,平均(37．0±2．4)岁.患者入选条件：肿瘤均未侵袭膀胱颈、后尿道、前列腺,无合并前列腺癌,且患者均行保留性神经的膀胱全切除原位回肠膀胱术治疗,实现原位尿流改道.观察入选患者手术成功率、手术时间、随访情况并采用男性性功能量表(BMSFI)进行术后调查.结果34例手术均成功,手术时间280~410 min,平均(310．0±10．2)min.随访6~80个月,34例均存活,无尿道复发,无转移.术后2个月20例(58．8％)有晨间自发性阴茎勃起现象.治疗后28例(82．4％)可有性生活.结论年轻膀胱癌患者采用保留性神经的膀胱全切除原位回肠膀胱术治疗效果理想,能维持患者勃起功能,改善患者生活质量,值得推广应用.

Ereectile function-preserving radical cystectomy with orthotopic urinary diversion (report of 34 cases)

Objective To study the retention of nerve cystectomy orthotopic ileal neobladder clinical efficacy in younger patients with bladder cancer,and provide the basis for clinical practice. Methods January 1 998 to June 2010 young bladder cancer patients to hospital for treatment of 34 ca-ses of cancer patients were enrolled invasive bladder neck,urethra,prostate and prostate cancer combined,and the patient underwent a full bladder retention nerve orthotopic ileal resection in the treatment of bladder,urinary diversion-situ observation of patients enrolled success rate,operation time,follow-up of the situation and the use of male sexual function scale (BMSFI)patients investi-gated. Results 34 cases were all successful,the operation time of 280 to 410 min,an average of (310.0±10.2)min.Followed up for 6 to 80 months,34 cases were alive,no urethral recurrence,me-tastasis.2 months after 20 cases (58.8%)had spontaneously morning erection phenomenon.28 cases (82.4%)of sexual life after treatment. Conclusions Young patients with bladder cancer retention nerve cystectomy with orthotopic ileal neobladder ideal treatment,patients can maintain erectile function,improve quality of life,it should be widely applied.