保留性功能的膀胱全切、乙状结肠直肠膀胱术疗效观察

A follow up study of radical cystectomy with preser vation of sexuality and colon sygmoideum and rectum conduit

目的探讨保留性功能的膀胱全切、乙状结肠直肠膀胱术的疗效。方法对26例男性膀胱癌患者采取保留性功能膀胱癌根治术,距直肠约18cm切断乙状结肠,将乙状结肠断端与直肠低位吻合。输尿管以乳头法植于乙状结肠膀胱。结果手术时间平均为360min,26例患者随访36个月,平均24个月。全部患者均可控排尿,新膀胱造影未发现输尿管返流。肾功能均正常,无电解质紊乱现象。21例保留了性功能。结论保留性功能的膀胱全切、乙状结肠直肠膀胱术,具有好的可控排尿,使大多数男性患者保留性功能,无电解质紊乱和肾功能损害。这种手术方法是可行的。

Objective To present a technique of radical cystectomy with preservation of sexuality and colon sygmoideum and rectum conduit.Methods Radical cystectomy with preservation of sexuality and colon sygmoideum and rectum conduit were performed for 26 male patients cut sigmoid colon at a distance of 18cm far from rectum and sutured the cut end of sigmoid colon with rectum.The ureters were implanted at the colon sygmoideum with antireflux nipple.Results The operation took 300 to 420 minutes with a mean of 360 minutes.26 cases have been followed up for 3 to 36 months with a mean of 24 months.Good continence has been achieved during day and night in all patients.On voiding cystograpmy,no reflux has been noted in all.Renal function and other laboratory findings have been normal.Sexuality have been preserved in 21 patients.Conclusions The radical cystectomy with preservation of sexuality and colon sygmoideum and rectum conduit are good continence.Most of patients preserve sexuality.With no electrolyte disorder or impairment of renal function.The technique is more feasible.