去管化乙状结肠储尿囊可控性尿流改道术(改良MainzⅡ式)临床疗效观察

Clinical Observation of Therapeutic Effect of Continent Urinary Diversion Using Detubularized Sigmoid Colon as Urinary Reservoirs(Modified MainzⅡ Method)

目的观察去管化乙状结肠储尿囊可控性尿流改道术（改良MainzⅡ式）临床效果。方法5例膀胱癌患者,膀胱全切术后采用改良MainzⅡ式,分析围手术期情况、术后控尿情况、贮尿囊容积、影像学检查情况、实验室检查情况、术后并发症。结果手术时间4.3～5.5 h,术中出血量300～545 ml,术后下床时间6～9 d,留置单J管时间8～13 d,留置尿管时间19～22 d,全部患者白天及夜间控尿良好。结论改良MainzⅡ式膀胱术操作简单,效果良好,能保证肠管的连续性和尿液可控性,并发症少,患者生存质量提高。

Objective To investigate the clinical outcome of diversion using detubularized sigmoid colon as urinary reservoirs. Methods We selected 5 patients with muscle-invading bladder carcinoma who underwent a Mainz pouchⅡ procedure after radical cystectomy. Peri-operative situation, postoperative continence, the mean volume of pouch, imaging, laboratory and post-operative complications were analyzed. Results Operation time, bleeding, single J catheter time and indwelling catheter time were 4.3--5.5 h,300--545 ml,8.0--13.0 d and 19.0--22.0 d respectively.Conclusion Modified MainzⅡ method is simple and safe,it is also a better alternative diver sion procedure easily accepted by surgeons and patients.