改良腹腔镜下全膀胱切除原位M形回肠代膀胱术

Modified Laparoscopic Cystectomy with Orthotopic M-shape Ileal Neobladder

[提要]2004年9月及2005年3月分别对2例膀胱癌患者施行改良术:先在腹腔镜下切除膀胱、前列腺,再利用下腹壁小切口行原位M形回肠代膀胱术。本术式改良之处在于:采用气囊导尿管牵拉对合代膀胱开口与尿道断端;代膀胱底部开口周围行荷包缝合以加固其强度;安置代膀胱造瘘管。2例患者术后恢复良好,无严重并发症,术后恢复自主控尿。本改良术式具有操作相对简单,利于术后恢复及训练控尿能力等优点。

2 cases of bladder carcinoma underwent modified procedure： bladder and prostate were removed by laparoscope and followed by the reconstruction of bladder using M-shape ileum in situ via mini-incision. Modification defined as： the neobladder and the urethra stump were pulled close by a ＂balloon catheter＂ technique, a purse string suture was performed on the fundus of neobladder around the orifice to enforce it, and a drainage tube was placed into the neobladder. The postoperative process was uneventful and the automatic micturition was restored in both cases. This modification is a simple and eutherapeutic procedure.