61例行膀胱全切原位W形回肠代膀胱术治疗临床研究

目的探讨膀胱全切原位w形回肠代膀胱术临床应用及疗效。方法2005年6月至2008年10月间本院采用膀胱全切原位w形回肠代膀胱术治疗61例膀胱肿瘤患者临床资料进行总结分析。结果手术均成功，手术时间9～13h，术中失血200—1200ml，平均650ml。术后未发现尿瘘肠瘘，肠粘连切口和盆腔感染术后随访6～28个月，平均15个月。术后3个月无输尿管扩张及肾积水，新膀胱形态良好。3例混合性癌及1例鳞癌和腺癌患者，在术后8～17个月后因肿癌转移死亡，其余58例均无瘤生存。结论膀胱全切原位w形回肠代膀胱术，手术简单，术后并发症少，复发少，术后性功能的恢复良好，尿失禁少，代膀胱贮尿排尿功能良好，无全身电解质紊乱，患者的生活质量满意。

61 routine urinary bladders all cut the home position W shape ileum generation of urinary bladder technique treatment clinical discussion

Objective Discusses the urinary bladder to cut the home position W shape ileum genera- tion of urinary bladder technique clinical practice and the curative effect. Methods In June,2005 12,008 dur- ing year October my courtyard uses the urinary bladder to cut the home position W shape ileum generation of uri- nary bladder technique to treat 61 example bladder neoplasm patient clinical material to carry on the summary a- nalysis. Results The surgery succeeds, surgery time 9-13 h,in the technique loses blood 200-1200 ml, average 650 ml. After the technique, had not discovered the urethral fistula intestines fistula, after the intestinal adhesion margin and the pelvic cavity infect the technique, makes a follow-up visit for 6-28 months, the average 15 months. The technique latter 3 month non-ureter expansion and the kidney water, the new urinary bladder shape is good. 3 examples mixing property cancer and I example scale cancer and adenoearcinoma patient, technique latter 8-17 months later, because swells the metastasis death, other 58 examples do not have the lump survival, Conclusion The urinary bladder all cuts the home position W shape ileum generation of urinary bladder tech- nique ,the surgery is simple, after the technique, the complication are few, recurs few, after the technique, the function restoration is good, urinates the incontinence to be few, a generation of arm stores the urine urination function to be good dimly, the non-whole body electrolyte disorder, patient＇ s quality of life is satisfied The key word bladder neoplasm urinary bladder all cuts the home position W shape ileum generation of urinary bladder technique clinical discussion.