原位新膀胱术与回肠膀胱术临床效果比较

目的：比较膀胱肿瘤患者膀胱全切术后行原位新膀胱术与回肠膀胱术的临床治疗效果及术后早期并发症。方法：选择我院2000-2009年行根治性膀胱切除术治疗膀胱尿路上皮细胞癌65例患者的临床资料，其中行原位新膀胱术31例，回肠膀胱术34例。比较两组一般情况、围手术期情况（术中失血量、手术时间、肠功能恢复时间、住院天数）以及术后早期并发症等指标。结果：两种术式在术中失血量（1140．32±492．82ml vs 920．91±410．48ml）、手术时间（464．81±79．37min vs 413．32±99．54min）、住院天数（47．68±7．53天vs41．09±8．12天）等方面差异有统计学意义（P〈0．05）。结论：原位新膀胱术较回肠膀胱术虽手术步骤复杂，术中出血较多，但因手术安全，可自主性控制排尿，明显提高患者的生活质量而易于接受，是值得推荐的膀胱替代手术方式，在根治性膀胱切除术中值得优先采用。

The Comparison of Efficacy Between Orthotopic Neobladder and Bricker Operation

Objective：To compare the Clinical curative effect and postoperative early complications between orthotopic neobladder and Bricker operation of patients who underwent radical cystectomy because of bladder tumor. Method： A retrospective review was done on 65 patients with transitional cell carcinoma of bladder after radical cysteetomy from 2000 to 2009,31 patients with orthotopic neobladder and 34 patients with bricker operation. Parameters associated with the general conditions, the surgical procedures（ amount of bleeding during operation, operative time, recuperative time of enteral function, the hospital stay）, early complications were compared between the two groups. Result：Only the amount of bleeding during operation, the time of operation,length of stay and between two groups with significance difference（P〈0.05）. Conclusion：Maybe orthotopic neobladder is more complicated,more amounts of bleeding during operation, compared with Bricker Operation,orthotopic neobladder is a safe and viable procedure,and it offers a better quality of life with autonomic urination and advocates its use when possible for bladder substitution in the patients with bladder carcinoma,it is a predominant technique for the treatment of bladder uroepithelium cancer in radical cystectomy.