摘要
目的探讨膀胱全切除术后原位M形回肠新膀胱的疗效。方法膀胱恶性肿瘤患者15例行膀胱全切除术,采用M形原位回肠新膀胱术进行尿流改道。结果围手术期无1例死亡,随访3-20个月(平均12.4个月)。膀胱容量(340±23.71)mL(210-430mL),膀胱充盈压为(20.12±0.64)cmH2O(13.50-33.91cmH2O),排尿膀胱压为(77.02±12.11)cmH2O(53.21-87.09cmH2O),残余尿(15.43±34.33)mL(3-88mL),最大尿流率(18.16±5.60)mL/s(11.38-19.17mL/s)。无明显输尿管梗阻及返流。未发现尿道残端复发肿瘤。无排尿困难者,白天均可控制排尿;术后大于6个月者无夜间遗尿,术后半年15例复查B超无肾积水表现,复查生化指标,肾功能电解质在正常范围内,1例术前肾积水及肾功能异常者术后为正常。结论原位回肠新膀胱术是较理想的膀胱全切术后的尿流改道方式。
Objective To evaluate the outcomes of M-shaped orthotopic ileal neobladder. Methods A total of 15 patients （14 males and 1 female） with malignant bladder tumors underwent M-shaped orthotopic ileal neobladder after radical extraperitoneal cystoprostatectomy. Results The 15 patients were followed up for 3 to 20 months with a mean of 12.4 months. The volume of the bladder was （340±23.71）mL postoperatively. Urodynamic examination showed that the peak voiding pressure was （77.02±12.11）cm H20. The maximum flow rate （Qmax） was （18.16±5.60） mL/s. The residual urine was （15. 43± 34. 33）mL. No remarkable ureter reflux and obstruction were found. No patient was detected to develop recurrent urethral carcinoma. Conclusion The neobladder is an ideal to treat invasive bladder tumor after total cystectomy.
出处
《现代泌尿外科杂志》
CAS
2006年第6期347-348,共2页
Journal of Modern Urology
关键词
膀胱肿瘤
膀胱切除术
尿路分流术
回肠新膀胱术
bladder neoplasms
cystectomy
urinary division
ileal orthotopic neobladder
