膀胱全切单乳头双输尿管一侧腹壁造口术

Bilateral ureter within single nipple for cutaneous ureterostomy after radical cystectomy

目的探讨膀胱全切术后尿流改道的方法。方法采用单乳头双输尿管一侧腹壁造口术式，即将右侧输尿管经腹膜后拉至左侧与左侧输尿管一并拉出腹壁，形成乳头，治疗３６例。结果乳头形成好，术后尿液引流通畅，无手术死亡及严重并发症。随访３个月～３５年，无乳头回缩塌陷、肾盂肾炎。经支架管逆行造影、大剂量静脉肾盂造影、Ｂ超检查，证实双肾无明显积水。结论该手术操作简单、安全、并发症少、成功率高，特别适合于年老体弱、全身情况差，不适宜行复杂手术的患者。

Objective To evaluate the effect of bilateral ureter within single nipple for cutaneous ureterostomy after radical cystectomy. Method Bilateral ureter within single nipple for cutaneous ureterostomy was performed on 36 patients after radical cystectomy. Result The nipple was formed well, and urinary drainage was patent. No death or severe complication occurred. The patients have been followed up for 3 months to 3.5 years. Urinary, electrolyte and renal functions were within normal levels. No pyelonephritis or hydronephrosis was observed in IVP, retrograde pyelography and/or sonographic examination of kidneys,no nipple constriction. A right ureter was pulled to the left retroperitoneum and formed a nipple with ureter left on the left abdominal wall. Conclusion This is a simple and safe operation, especially suitable to the old and weak patients.