楔形胃代膀胱术与乙状结肠代膀胱术远期功能评价与分析

Analysis of long-term outcome of stomachal orthotopic neobladder and sigmoid orthotopic neobladder

目的楔形胃代膀胱术与乙状结肠代膀胱术根治膀胱癌的远期功能评价与并发症分析。方法回顾性分析该院1998～2008年159例膀胱癌根治原位新膀胱患者临床资料,其中83例行楔形胃代膀胱术(胃代膀胱组),76例行乙状结肠代膀胱术(结肠代膀胱组),比较两组患者新膀胱远期贮尿功能和远期排尿功能,以及两组患者并发症的发生率。结果结肠代膀胱组患者新膀胱远期贮尿功能优于胃代膀胱组(P<0.05),胃代膀胱组新膀胱远期排尿功能优于结肠代膀胱组(P<0.05),胃代膀胱组患者并发症发生率低于结肠代膀胱组(P<0.05)。结论楔形胃代膀胱术储尿功能较乙状结肠代膀胱术稍差,但排尿功能参数更接近于生理膀胱,远期并发症少。

Objective To evaluate the long-term outcome and complications of orthotopic neobladder and sigmoid orthotopic neobladder. Methods We retrospectively reviewed the long term outcome and complications of the 159 patients accepted radical bladder cystectomy and urethra reconstruction from 1998 to 2008.83 patients reconstructed the urethra with wedge shaped stom- ach,and 76 patients with sigmoid colon. Results In patients with sigmoid orthotopic neobladder,the bladder＇s long-term urine-store function was better than patients with stomachal neobladder（P〈0.05）. In patients with stomachal neobladder, the bladder＇s long- term urinary function and the occurrence of complications were better than patients with sigmoid orthotopic neobladder（P〈0.05）. Conclusion The stomachal orthotopic neobladder is more close to the physiological bladder and with less infection,however,part of the patients may suffer urethralgia.