阑尾脐部造口可控性回结肠膀胱术后远期并发症

Long-term complications of continent ileocolic urinary reservoir with in situ appendix conduit through umbilicus

目的探讨阑尾脐部造口可控性回结肠膀胱术后远期并发症及其处理方法。方法回顾分析阑尾脐部造口可控性回结肠膀胱术后患者临床资料37例,并进行长期随访观察,随访时间85～136个月,平均109个月。结果随访37例中出现远期并发症15例(40.5%),其中贮尿囊内结石形成2例、输出道狭窄插管导尿困难3例、输尿管吻合口狭窄致肾积水7例、贮尿囊内异物2例、输出道黏膜外翻1例;均作出相应处理,症状得到控制。结论阑尾脐部造口可控性回结肠膀胱术后并发症与术中设计及术后日常护理不当相关,术后日常护理对预防减少远期并发症有重要作用。

Objective To evaluate the long-term complications of appendix conduit through umbilicus and their management. Methods continent ileocolic reservoir with in situ We reviewed 37 patients with bladder diseases who underwent the surgery of continent ileocolic diversion with in situ appendix conduit through umbilicus and followed up for 85 to 136 months （mean 109 months）. Long-term postoperative complications were documented. Results Complications occurred in 15 cases （40.5%）, including stone formation in urinary pouch in 2 cases, efferent limb stricture and difficulty in catheterization in 3 cases, ureter stricture and hydronephrosis in 7 cases, foreign matter in urinary pouch in 2 cases, efferent limb mucosa exstrophy in 1 case. These complications were correctly treated and good results were achieved. Conclusion Long-term complications of continent ileocolic diversion with in situ appendix conduit through umbilicus were related to nursing in daily life after operation and unsuited design in operation. Nursing in daily life is considered very important in preventing postoperative complications.