摘要
目的 介绍一种腹腔镜下膀胱根治性切除患者行经腹膜外途径输尿管肚脐造口(umbilical stoma for bilateral ureterostomy,USBU)新技术。方法 以3例男性高级别浸润性膀胱尿路上皮癌患者为例,患者进行腹腔镜下膀胱根治性切除USBU术,包含游离输尿管、建立腹膜外通道(游离盆、腹腔腹膜外间隙,将输尿管从通道拉出)、肚脐造口等步骤。结果 3例患者手术均顺利完成,未出现严重术后并发症,术后患者仅需要1个造口袋。术后3/6个月拔除双侧输尿管支架管,随访至术后8个月,均未发现肾积水及肾功能损害。结论 USBU术式是一种相对于传统经皮输尿管造口术的改良术式,具有术后留置输尿管支架管时间短、保护输尿管正常蠕动功能、仅用1个输尿管造口袋等优点,是一种安全、可行的尿流改道术式。
Objective:To describe a new technique of umbilical stoma for bilateral ureterostomy(USBU)in the specific surgical procedures of 3 male patients with bladder cancer during laparoscopic radical resection of bladder cancer.Methods::Three patients with bladder cancer were conducted to introduce the key step of USBU during radical cystectomy by laparoscope,which involved separating bilateral ureters,establishing an extraperitoneal passage(dissociating the extraperitoneal space of each side of the pelvis and abdomen,and pulling out of the ureter through each channel).Results::The operation was successfully completed in all the 3 patients without serious postoperative complications,and only an ostomy bag was required.Bilateral ureteral stents were removed at 3/6 months after operation,and no hydronephrosis was found during follow-up until 8 months after operation.Conclusion:This technique is an improvement of the traditional cutaneous ureterostomy,which has the advantages of not needing long-term indwelling ureteral stents,protecting the normal peristaltic function of the ureter,and using only one ureterostomy bag,and it is a safe and feasible urinary diversion.
作者
钟浩
徐之红
郭兆新
张永振
任强强
刘照旭
ZHONG Hao;XU Zhihong;GUO Zhaoxin;ZHANG Yongzhen;REN Qiangqiang;LIU Zhaoxu(Department of Urology,The Third People's Hospital of Linyi,Linyi 276023,China;Department of Urology,Qilu Hospital of Shandong University,Jinan 250012,China;Department of Urology,People's Hospital of Wucheng,Dezhou 253300,China)
出处
《山东第一医科大学（山东省医学科学院）学报》
CAS
2023年第3期161-165,共5页
Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences
关键词
腹腔镜
膀胱根治性切除
输尿管肚脐造口
膀胱癌
laparoscope
radical resection of bladder cancer
extraperitoneal
umbilical stoma for bilateral ureterostomy
bladder cancer
