原位回肠与乙状结肠两种膀胱替代术尿控疗效的临床观察

目的比较根治性全膀胱术后,原位回肠和乙状结肠新膀胱的尿动力学结果、尿控差异。方法膀胱癌患者行标准根治性膀胱全切术后获得随访39例,22例采用原位回肠新膀胱术作原位膀胱替代术(A组),17例采用原位乙状结肠新膀胱术(B组)。术后12个月比较两组尿控情况、储尿囊及流出道的尿动力学检查结果。结果 A组白天完全获得尿控率略高于B组(92.2%vs.89.1%),但夜间尿控率显著高于B组(68.3%vs.45.2%)(P<0.05)。A组新膀胱容量、顺应性高于B组(P<0.05)。结论与原位乙状结肠新膀胱术比较,回肠新膀胱有更大的容量、更好的顺应性、更高的夜间尿控率。

Comparison of efficacy of continence between sigmoid and orthotopic ileal neobladdder in patients underwent radical cystectomy

Objective To compare the efficacy of continence rates and urodynamic parameters of the sigmoid and orthotopic ileal neobladdder in the patients underwent radical cystectomy.MethodsA total of 39 cases with neobladdders after radical cystectomy was followed up,of whom 22 cases underwent orthotopic ileal neobladder reconstruction(group A) and 17 cases underwent sigmoid neobladder reconstruction(group B).The continence and urodynamic parameters were compared between two groups at a median time after surgery of 12 months.Results Compared to group B,the complete daytime continence was slightly higher in group A(89.1% vs.92.2%),but the functional nocturnal continence in group A was significantly higher(45.2% vs.68.3%)(P<0.05).The urodynamic data showed that the patients in group A had larger initial volume and better compliance than those in group B(P<0.05).Conclusion Compared to sigmoid neobladder reconstruction,orthotopic ileal neobladders have larger intial volume,greater compliance and better nocturnal continence.