环形乙状结肠全膀胱置换术

Circular reconstruction of a segment of sigmoid for bladder replacement

为了寻求更理想的膀胱替代术式，１９９０年１月至１９９５年１２月，自行设计并施行２２例环形乙状结肠全膀胱置换术。取乙状结肠３０～３５ｃｍ，无水乙醇灭活肠粘膜功能细胞，对端缝合做成环形与尿道对接。术后５５天内，清醒状态下尿自控１００％，睡眠状态下尿自控９５４％。随访６～７２个月，２０例新膀胱有足够的容量，良好的顺应性和控尿机能。手术操作简单，并发症少，是理想的膀胱替代术式。

An isolated segment of sigmoid with the mucous membrane treated by pure alcohol was used for bladder replacement in 22 male patients with bladder cancer after total cystectomy.The isolated sigmoid segment,30～35cm in length,was anastomosed end to end so as to form a circle with the urethra anastomosed to it.The patients have been followed up for 6 to 72 months.Continence and normal micturition have been achieved in all during day time and in 95.4% when asleep and the capacity of the neobladder has been ideal.The procedure is simple with minimum complication providing an alternative technique for bladder replacement.