Studer回肠膀胱术后早期贮尿囊功能的评价

目的 探讨Studer回肠膀胱术后早期贮尿囊功能状态。方法膀胱癌患者16例。男13例，女3例，平均年龄59岁。病程2～6年，平均3年。其中原位癌1例、T1 1例、T2 12例、T3 2例。均施行根治性膀胱全切除术及Studer回肠膀胱术。采用影像学、尿动力学检查和控尿状态评估，评价新膀胱的功能。结果12例获随访，平均随访10个月。术后1个月因肿瘤肺转移死亡1例，术后13个月因肿瘤脑转移死亡1例，其余10例无瘤生存。8例术后3～6个月行尿路影像学检查，上尿路形态、功能正常。5例剩余尿60～100ml，3例剩余尿＜20ml。6例行尿动力学检查，自由尿流率17～25ml／s，平均21ml／s；最大膀胱容量300～450ml，平均350ml；贮尿时（平均350m1）膀胱最大压力18～28cmH20（1cmH2O=0．098kPa），平均24cmH2O。11例（92％）能够白天控尿，其中10例（83％）夜间也能够很好控尿。结论Studer回肠膀胱的贮尿和排尿功能较理想，多数患者术后控尿能力满意。

Studer neobladder and its continence evaluation

Objective To evaluate the continence status of neobladder with means of Studer technique following radical cystotectomy. Methods Sixteen cases of Studer procedure were conducted among the patients with advanced transitional cell carcinoma of urinary bladder from May 2004 to April 2005. The patients were comprised of 13 male and 3 female with an average age of 59 years. The patients were examined urodynamically to test their continence status post operatively. Results All cases were diagnosed with TCC. Twelve of 16 cases were followed up with an average time of 10 months. One died 1 month after operation by lung metastasis, and another one died of brain metastasis at 13 months postoperatively. The rest of them were all tumor-free survival during follow-up. Urogra phy was conducted in 8 cases at 6 months postoperatively, 5 cases had residual urine over 60 ml, 3 less 20 ml. Six patients underwent urodynamic test, the free flow rate was 17-25 ml/s, maximal bladder capacity was 300-450 ml, maximal bladder pressure in storage phase was 18-28 cm H2O. Eleven patients (92%) got excellent urinary continence. Conclusions Studer procedure plays an important role in treating advanced TCC of urinary bladder. The neobladder could be one of the ideal procedure with good urinary continence.