Roux-y乙状结肠新膀胱术

The Roux-y sigmoid neobladder

目的评价Roux-y乙状结肠新膀胱术在尿流改道中的应用疗效。方法研究分两组,Ⅰ组,22例,行Roux-y输尿管乙状结肠、乙状结肠直肠吻合术;Ⅱ组,21例,行低张力抗尿粪逆流Roux-y乙状结肠新膀胱术。结果Ⅰ组肾盂肾炎3例,肾积水2例,轻度酸中毒3例,残余尿量为0～18m,平均7.6ml,膀胱容量220～360ml,平均287ml;Ⅱ组2例偶有发热,无肾积水和酸中毒,残余尿为0ml,膀胱容量350～560ml,平均480ml。结论低张力抗尿粪逆流Roux-y乙状结肠新膀胱术是一种安全、创伤小和有效的可控尿流改道方法,提高了病人的生活质量。

Objective To assess the therapeutic effects of Roux-y sigmoid neobladder for urinary diversion.Methods Roux-y ureterosigmoidostomy and sigmoidorectostomy were performed in 22 cases of group 1 Low tension,anti-reflux Roux-y sigmoid neobladder were performed in 21 cases of group 2.Results For Group 1 ,three patients developed pyelonephritis,two patients developed hydroneprosis and three patients developed mild metabolic acidosis, the postvoiding resdual was 7.6ml（0- 18ml） and the cystometric capacity was 287ml（220- 360ml）.For Group 2, Besides occasional fever happened in 2 cases ,there was neither hydronephrosis nor disorder of acid-base balance, the postvoiding resdual was 0ml and the cystometric capacity was 480ml（350- 560ml）. Conclusion The low tension Roux-y sigmoid neobladder is a feasible ,safe and effective method for continent urinary diversion. It is able to provide good quality of life.