去带乙状结肠原位膀胱术20例临床分析

Detenial sigmoid neobladder report of 20 cases

目的探讨去带乙状结肠原位膀胱术治疗膀胱癌的临床疗效.方法膀胱癌20例,其中男18例,女2例,年龄33～76岁,平均61岁.均采用根治性膀胱切除及去带乙状结肠新膀胱术治疗.结果 20例患者随访6～48个月,平均18个月.患者血Cr、BUN均正常,未出现酸中毒.膀胱造影仅1例出现单侧输尿管返流.白天可自控排尿17例,尿失禁3例.新膀胱容量230～500ml（平均330 ml）,新膀胱充盈时最大压力16～50 cmH2O.结论该术式操作简单,并发症少,疗效可靠,值得临床推广运用.

Objective To investigate the clinlic therapeutic result of detenial sigmoid neobladder after radical cystectomy. Methods 20 patients with bladder cancer（18 males and 2 females;age range from 33 to 76 years） were admitted and underwent radical cystectomy and detenial sigmoid neobladder. Results All the 20 patients were fol- lowed up for a mean of 18 months（range from 6 to 48 months）. The blood Cr and BUN levels were both in the normal range without acidosis in all the cases. Only 1 had unilateral ureteral urine reflux during cystography. 3 of the 20 cases were incontinent,but 2 of the 3 cases could control urination by being woken up at night. The capacity of the neobladder was 230 to 500ml with a mean of 330ml and the maximal pressure of the neobladder during filling was 16 to 50cmH20. Conclusion As a simple operation the detenial sigmoid neobladder can be performed easily with less complications and more reliable results. This operation may be generally applied in clinical practice.