肠代膀胱术中输尿管吻合方法的改进

目的：探讨肠代膀胱输尿管吻合的理想方法。方法：对60例肠代膀胱术后118侧作肠代膀胱输尿管吻合的患者进行随访．对不同吻合方法的效果作对比分析。采用黏膜下隧道法吻合6例11侧，黏膜沟法吻合10例19侧，改良黏膜沟法吻合42例84侧．改良乳头种植法吻合2例4侧。结果：吻合一侧所需时间．黏膜下隧道法和黏膜沟法为25min，改良黏膜沟法8min，改良乳头种植法5min。无吻合口漏及输尿管反流并发症，吻合口狭窄均见于黏膜下隧道法。结论：改良黏膜沟法和直接种植法是肠代膀胱输尿管吻合的理想方法。

Improvement of ureterointestinal anastomosis in orthotopic intestinal neobladder

Objective: To investigate the ideal method for ureteral implantation in orthotopic neobladder. Methods:The 118 upper urinary tracts in 60 patients underwent orthotopic neobladder was followed up and the outcome of different techniques for ureteral implantation were compared. Results:Implantation was carried out in 11 renoureteral units with tunneled anastomosis,in 19 with Le Duc technique,in 84 with modified Le Duc technique and in 4 with direct anastomosis. The time used for anastomosis was 25 minutes for tunneled anastomosis and Le Duc technique,8 minutes for modified Le Duc technique,and 5 minutes for direct ananstomosis. There was no complication except 2 anastomotic strictures followed tunneled anastomosis. Conclusions:Modified Le Duc technique and direct ananstomosis were the ideal methods for ureteral implantation in orthotopic neobladder.