腹膜后输尿管回肠吻合回肠膀胱术

Retroperitoneal Ureteroileostomy in Ileal Conduit Urinary Diversion

采用腹膜后输尿管回肠吻合法作腹膜外回肠膀胱术15例,其中膀胱肿瘤病理分期 T_1期1例,T_2期6例,T_3期8例。多发性复发性膀胱肿瘤已接受过经尿道膀胱肿瘤电切术(TUR-BT)或膀胱部分切除术者10例(10/15)。结果认为:用腹膜后输尿管回肠吻合法将回肠段放置于腹膜后,保留了腹膜外回肠膀胱术的优点,特别适用于有膀胱部分切除或输尿管膀胱移植手术史,盆腔粘连较甚,输尿管截取较短的患者。在输尿管跨过髂血管水平处截断输尿管,即能满足吻合之需。回肠膀胱造瘘口处术后即佩带腰侧集尿器,避免了尿液对伤口的污染,有利切口的一期愈口,降低了术后护理强度和费用。

Retroperitoneal ureteroileostomy was used in ileal conduit urinary diversion.A total of 15 patients with bladder cancers was treated by this operation.Among which,10 cases had already received TUR-BT or partial cystectomy because of multiple and recurrent bladder tumors.The pathologic stage of bladder cancer in 15 patients was as follow:1 case of T_1 stage,2 cases of T_2 stage and 8 cases of T_3 stage.All patients were healing by first intention.No complication of urinary fistula and intestinal obstruction was occured.Retroperitoneal ureteroileostomy ileal conduit urinary diversion can not only preserve the advantages of extraperitoneal ileal conduit,but also avoid the shortage of putting ileum in front of peritoneum.This operation was suited for the patients with short free iliac mesentery or ureter,and repeated pelvic operation