女性原位回肠代膀胱术的临床应用

目的:总结女性膀胱全切患者行原位回肠代膀胱术的临床疗效。方法:回顾性分析1998年1月～2006年2月36例女性膀胱全切,原位回肠代膀胱患者的临床资料。36例患者,年龄48～65岁,平均56岁。其中移行细胞癌34例,腺癌2例。原发肿瘤22例,复发性肿瘤14例。多发性非肌层侵犯肿瘤(Ta～T1)12例,浸润性膀胱肿瘤(T2～T3)24例。结果:36例手术平均时间270min(210～330min),输血量平均400ml(0～1000ml)。术后随访6～72个月,平均26个月。术后6个月昼夜控尿率分别为94%(34/36)和92%(33/36)。2例排尿可控过度,需间歇导尿。术后6个月IVU检查无输尿管狭窄和反流。血电解质和肾功能正常,无尿道残端肿瘤复发。结论:原位回肠代膀胱术治疗女性膀胱癌患者临床疗效满意,可作为广泛开展的术式。

Orthotopic ileal neobladder in women

Objective:To Summarize the therapeutic effects of orthotopic ileal neobaldder in women.Methods:The clinical data of 36 cases of bladder carcinoma who uuderwent radical cystectomy and orthotopic ileal neobladder from January 1998 to February 2006 were analyzed retrospectively.The mean age was 56 years(range,48-65 years).Pathology showed transitional cell carcinoma in 34 cases,bladder adenocarcinoma in 2 cases.Of them,22 cases were of primary tumors and 14,of recurrent ones.12 cases were multifocal non-muscle invasive tumor(Ta-T1)and 24 cases were muscle invasive tumor(T2-T3).Results:The mean operative time was 270 min(range,210-330 min),and the mean blood transfusion was 400 ml(range,0-1 000 ml).All patients were followed up for a mean of 26 months(range,6-72 months).At 6 months after surgery the continence rate was 94%(34/36)during the day and 92%(33/36)at night.Two cases needed intermittent catheterization due to hyper-continence.IVU Showed no ureteral stenosis and reflux.Renal function and electrolyte metabolism were normal.No urethral tumor recurrence existed.Conclusions:The results of orthotopic ileal neobladder in women are satisfactory and this surgical technique can be used widely.