低压可控性回肠代膀胱术17例报告

Low pressure continent ileal reservoir for bladder substitution (Report of 17 cases)

目的 :探讨膀胱全切除术后患者理想的膀胱替代术式。方法 :采用 W形贮尿囊及球形贮尿囊代膀胱作低压可控性回肠代膀胱术治疗因膀胱癌而行膀胱全切除术患者 17例。结果 :随访 0 .5～ 2年 ,经代膀胱造影、测压和 IVU检查 ,效果满意 ,仅 5例术后出现不同的并发症 ,经对症处理均治愈 ;术后膀胱容量达 2 40～ 5 6 0 ml,膀胱静压为 2 .44～ 4.6 8k Pa。结论 :本术式代膀胱内压低、容量大、抗反流效果好 ,无明显输尿管梗阻及肾盂积水 ,无水电解质紊乱 ,是较理想的膀胱替代手术。

Purpose:To improve the quality of patient′s life after radical cystectomy. Methods:The ansa of mesenterial intestine was overlapped to a w pouch or a globe pouch with double antireflux and was used as a low pressure ileal pouch for bladder substitution for 17 cases of bladder carcinoma. Results: The patients were followed up for 6 months to 2 years after the operation. Low pressure ileal reservoir for bladder substitution has many advantages such as low intra-reservoir pressure, large volume, antiureteral reflux, no hydropic and electrolytic disorder, no ureter expansion, no hydronephrosis. Conclusions: Low pressure w type or globe type ileal reservoir is an ideal operation for the patient with bladder carcinoma.