膀胱全切除后不同尿流改道术治疗肌层浸润性膀胱癌的辩证思考

Dialectical Thinking of Different Urinary Diversions after Radical Cystectomy for Muscle Invasive Bladder Cancer

肌层浸润性膀胱癌在膀胱全切后尿流改道术经过了3个重要阶段,即不可控尿流改道术、可控性尿流改道术以及原位膀胱重建术,这三种术式在治疗目的、手术和解剖技术上有共同之处,但在手术适应证、手术方式、手术并发症发病率上又有很大的不同。这种对立统一的关系对指导临床工作有重要意义。

There are three major stages of urinary diversions after radical cystectomy,they are non-continent diversion,continent diversion and orthotopic neo-bladder. There are significantly difference among the three kinds of diversion about selection of adaptation,operative method and the incidence of complications in bladder cancer operative therapy. This unity of opposites is important for clinical work.