可控膀胱术46例疗效观察

目的：探讨可按膀胱术后的并发症和防治。方法：分析46例膀胱恶性肿瘤患者可控膀胱术后临床资料。结果：随访45例(97．8％)，随访6--116个月，中位数61个月。术后近期并发症为尿瘘、肠瘘、肠梗阻；远期并发症为肾积水、输尿管返流、潴尿囊过度扩张、潴尿囊出血、尿路感染、泌尿系结石、代谢紊乱、肾功能损害、阳痿、肿瘤复发及转移。结论：全膀胱切除并可按膀胱术为膀胱恶性肿瘤疗效肯定的治疗方法，但或多或少地存在各类并发症，危害肾功能并影响预后，新的手术方式及治疗方法的改进、术后护理的加强，可望减少并发症的发生率。

Continent Urinary Reservior (A Retrospective Study of 46 Cases)

Objective:To probe into prevention of complications after continent urinary reservoir.Methods:A retrospective study was made on 46 cases of bladder malignancy with continent urinary reservoir. Results:Forty-five patients (97.8%) were followed up. During a mean follow-up of 61 months (range 6 to 116),the early complications included urinary fistula, intestinal fistula and intestinal obstruction;the late complications included hydronephrosis, ureter reflux, over extention of reservoir, reservoir bleeding, efferent obstruction, urinary tract infection, lithiasis, metabolic disturbance, renal function lesion ,erectile disfunction, port recurrence and metastasis of malignancy. Conclusions:The radical cystectomy with continent urinary reservoir is the classic surgical method for bladder malignancy. But there are different kinds of postoperative complications. They do harm to renal function and greatly affect the prognosis. The incidence of complications could be reduced by using new surgical methods, improving surgical techniques and postoperative nursing.