乙状结肠原位新膀胱术后远期并发症及其防治

Prevention and Treatment on Late Complication of Orthotopic Sigmoid Neobladder

通过对30例膀胱根治性切除乙状结肠原位新膀胱的跟踪随访，总结分析此术式的晚期并发症及其防治方法。2003年1月至2007年6月我院共施行膀胱根治性切除乙状结肠原位新膀胱术30例，病例随访2．5年～6年。随访期间发生的并发症有：新膀胱结石2例（6．7％），肾盂输尿管扩张肾功不全2例（6．7％），代谢性酸中毒4例（13．3％），尿道残端癌1例（10％），尿失禁4例（13．3％），尿潴留2例（6．7％）。膀胱根治性切除乙状结肠原位新膀胱术作为治疗膀胱癌的重要手术方法被广泛接受。但其术后远期并发症更应该得到重视。患者术后顺利出院不代表治疗已经结束，术后长期随访至关重要。

To analyze and sum up late complication of orthotopic sigmoid neobladder,and to prevent and treat the complication 30 consecutive patients from January 2003 to June 2007 with orthotopic sigmoid neobladder constructed after radical cysteetomy were followed up for 2.5 to 6 years. During the followup： neobladder calculi in 2（ 6.7 % ）, hydronephrosis and renal inadequacy in 2（6.7 %）, metabolic acidosis in 4 （13.3 %）, urethral metastatic carcinoma in 1（3.3%）, incontinence in 4（13.3 % ）and urinary retention in 2（6.7 % ）. Orthotopic sigmoid neobladder is an important operational method after radical cystectomy, but more attention should be paid to the postoperative late complication. Treatment is not about to completely finish even if the patients can recover favorably and leave hospital. Therefore,long-term followup is vital after operations.