下腹壁人工外尿道成形在回肠膀胱术中的应用

Application of low abdominal external urethroplasty in ileocystoplasty

目的为回肠膀胱术患者重建人工外尿道,改善尿液收集方法。方法1995年8月至2005年7月,为17例膀胱癌患者,在施行膀胱全切除、回肠膀胱术后,在右下腹壁设计两个反向梯形皮瓣对合为管状作为被覆,以回肠膀胱远端段肠瓣作为衬里,共同建造腹壁管状人工外尿道。17例人工外尿道中,16例与回肠膀胱术同时形成,1例在回肠膀胱腹壁膀胱造口1年后成形。在管状外尿道套接由阴茎套及普通尿袋改装的收集器进行尿液收集。结果17例下腹壁人工外尿道均一次手术获得成形,供瓣区直接闭合,伤口一期愈合;尿流呈点滴或线状,收集容易,污染少。结论该腹壁人工外尿道成形术操作简单,安全;尿液收集方便,卫生,费用低廉,适合回肠膀胱患者采用。

Objective To rebuild artificial external urethroplaspy and improve collecting-urine method for the patient with ileocystoplasty. Methods Abdominal tube shaped artificial external urethra were rebuilt by designing two reverse ladder shaped skin flal~,using synthetic tube shape as coveting,and using distant ileum flap as lining in total cystectomy and ileocystoplasty for 17 patients with urinary bladder carcinoma during August 1993 to July 2005. Urine was collected by connecting tube shaped external urethra with condom and urine package. Results The operation of 17 artificial external urethra succeeded all. The wound of the operation healed one stage. Urine collecting was easy and less con^mination. Conclusion Artificial external urethroplasty with lower abdominal wall skin-flap and ileum-flap is simple,safe,and suitable to the patients with ileocystoplasty. Urine collecting is convenient and hygiene and low-price.