经脐造口式可控性结肠膀胱术

Umbilical stoma for the construction of a continent colonic reservoir

1991年11月～1994年6月为9例膀胱癌患者施行了膀胱全切除、经脐造口式可控性结肠膀胱术，即将盲升结肠30cm剖开后S形折叠重组形成贮尿囊，输尿管种植于贮尿囊后壁，利用缝合器缩窄末段8cm回肠形成抗尿失禁输出道，经脐部作平坦式腹壁造口。术后随访1～4年，经贮尿囊测压造影、静脉尿路造影等检查，效果良好。认为该术式抗尿失禁效果好，导尿顺利；贮尿囊容量适中且压力低，无明显输尿管梗阻及返流；手术方法简单，术后晚期并发症少。

A new type of continent colonic reservoir was performed between Nov. 1991 andJun. 1994 for 9 patients after total cystectomy. 30 cm of cecocolon was detubularized and reformed by S-shape overlap to form a pouch. The ureters were implanted to the posterior wall of the pouch.8 cm of terminal ileum was tapered over a F16 catheter to form a continent efferent tract and brought out to make a flat umbilical stoma. All cases were followed up for 1 to 4 years. Urine continence has been achieved in all cases and self catheterization could be easily undertaken. The maximum volume of the pouch was 400~500 ml. The basal and intermittent pressure were 0. 98 to 1. 96kPa and 1. 96 to 3. 93 kPa respectively. There has been no evidence of ureteral reflux or hydronephrosis.