改良膀胱全切、原位回肠代膀胱术的疗效观察

目的:探讨膀胱根治术后行尿流改道的方法。方法:对17例男性膀胱癌患者行膀胱全切、原位回肠代膀胱术,采用改良的手术方法。结果:手术时间平均230min;输血量平均480ml;全部病例可完全控尿,需夜间定时排尿;膀胱最大贮尿量平均330ml,剩余尿均小于80ml。17例全部随访,时间7～48个月,平均19个月。术后仅发生单侧输尿管反流1例,肾功能衰竭死亡1例,肿瘤转移死亡1例。无电解质紊乱发生,未发现尿道肿瘤复发。结论:改良膀胱全切、原位回肠代膀胱术是膀胱根治术后尿流改道的较为理想术式。

A modified ileal orthotopic neobladder (Report of 17 cases)

Objective:To present experience with modified ileal orthotopic neobladder.Methods:Radical cystectomy and ileal neobledder were for 17 male patients adopted improved surgical method.Results:17 cases of ileal neobladders have been followed up for 7 to 48 months with a mean of 19 months. The operation took 200 to 330 minutes with a mean of 230 minutes. The intraoperative blood transfusion was 360 ml to 1080 ml with a mean of 480 ml. All patients achieved excellent continence.whereas possessory patients needed time-lapse emiction at nighttime. The mean bladder capacity for the entire group was 330 ml.Residual urine was less than 80 ml. Voiding cystography showed unilateral ureter reflux in 1 case after operation. 1 case died for functional renal failure and another died for cancer metastasis. No patient suffered for electrolytical disturbance and urethral tumour recurrence.Conclusions:The modified radical cystectomy and ileal neobledder was perfect surgery artifice.