改良VIP回肠代膀胱术(附12例报告)

Modified vesica ileal padovana (report of 12 cases)

为更好地解决膀胱癌患者膀胱全切除术后的贮尿和控尿问题，采用改良ＶＩＰ回肠代膀胱术治疗１２例膀胱癌患者。其方法为截取末段回肠４０ｃｍ进行除管和回肠双重折叠作为贮尿囊，输尿管与回肠行ＬｅＤｕｃＣａｍｅｙ吻合术，回肠与后尿道端端吻合建立尿流输出道。随访６～２８个月，平均１１个月。结果：１０例白天完全控尿，２例增加腹压时有尿失禁；９例晚间完全控尿，２例部分尿失禁，１例完全尿失禁。代膀胱内压低，容量大（平均４００ｍｌ）；无输尿管返流和剩余尿。

Construction of a modified vesica ileal padovana (M VIP) was carried out after total cystectomy for 12 cases of bladder cancer. The technique consisted of detuberization and reconfiguration of 40cm of ileum, Le Duc's uretero ileal anastomosis and urethro ileal anastomosis. The patients have been followed up for 6～28 months with a mean of 11. 10 patients claimed perfect continence during daytime while the other 2 reported leakage on abdominal straining. When asleep, complete urinary continence has been claimed by 9, partial leakage by 2 and constant leakage by 1. The internal pressure of the reservoir has been low with a mean adequate volume of 400ml. No ureteral reflux or residual urine has been observed. The surgical technique was described in detail and was recommended for clinical application.