异位可控膀胱术后合并贮尿囊结石的内窥镜治疗

Endoscopic treatment of ectopic controlled bladder pouch stones following radical cystectomy

目的:探讨全膀胱切除异位可控膀胱术后合并贮尿囊结石的内窥镜治疗方法。方法:2003年3月～2011年5月期间对11例全膀胱切除异位可控膀胱术后合并贮尿囊结石的患者采用摄像监视系统、灌洗泵、不同内窥镜及碎石系统经输出道进入贮尿囊进行碎石及取石,其中3例阑尾输出道患者采用F8/9.8Wolf输尿管硬镜或输尿管软镜进入贮尿囊内行气压弹道碎石或钬激光碎石;4例回肠输出道患者采用F19.5Wolf尿道膀胱镜进入贮尿囊内行气压弹道碎石或钬激光碎石;4例回肠输出道患者采用F21Wolf肾镜进入贮尿囊内行EMS超声碎石。结果:11例患者经输出道将贮尿囊内结石全部取出,并发症出现少,对输出道的抗尿失禁作用影响少。结论:对全膀胱切除异位可控膀胱术后合并贮尿囊结石,可采用不同的碎石系统和不同的内窥镜经输出道进入贮尿囊内进行碎石,其并发症少,效果满意。

Objective： To investigate the endoscopic treatment of ectopic controlled bladder pouch stones fol lowing radical eystectomy. Methods： From March 2003 to May 2011, 11 patients with ectopic controlled bladder following radical cystectomy had pouch stones, received endoscopic treatment in the assistance of video surveillance system, pumps, endoscopy and lithotriptors. We summarized the effectiveness of this method. Results：Three cases with appendiceal conduit were dealed with F8/9.8 Wolf rigid ureteroseope or flexible ureteroscope and API. or Ho ： YAG laser as the lithotriptor. 4 cases with ileal conduit were dealed with F19.5 Wolf cystoscope, and the cyslo- scope was inserted into the urine reservoir capsulefor pneumatic lithotripsy or holmium laser lithotripsy. 4 cases with ileal conduit were dealed with F21 Wolf nephroscope, the nephroscope was inserted into the urine reservoir capsule and stones were breaked using EMS ultrasonic lithotripsy. All 11 patients were rendered stone free, and no severe complication was noted. Conclusions= Endoscopic treatment of ectopic controlled bladder pouch stones fol- lowing radical cysteetomy was safe and effective, with little complications.