改良Studer回肠膀胱成形术15例报告

Modified studer′s procedure

目的 :探讨理想的膀胱代替手术。方法 :回顾性分析 10年来所施行的改良 Studer回肠膀胱成形术 15例的手术情况 ,对 Studer作了三点改良 :1将近端尿道输入瓣由 2 0 cm改为 15 cm;2尿道内放入 F2 2 导尿管 ;3远端 2 / 3肠瓣完全去管道。结果 :15例平均随访 15个月 ,1例再手术 ,1例出现肾积水 ,白天和夜间尿液可控率分别为 95 %和 93%。结论 :改良 Studer回肠膀胱成形术并发症少 ,成功率高 ,符合容量适当、低压、可控、可保护上尿路的理想术式要求。

Purpose:Several different methods to construct a bladder substitute after cystectomy have been described, we evaluated our experience with modified ileal neobladder during the last 10 years.Methods:We reviewed retrospectively the data of 15 patients who underwent construction of modified ileal neobladder originally described by Studer. The mean follow-up period was 25 months (range 6～72 months).Results:Daytime and nighttime continence rates were 95% and 93%. One patient had voiding difficult which resulting in hydronephrosis. Few complications were noted, only one experienced reoperation. Conclusions:The results reveal that the ileal neobladder is a easily constructed pouch with a low complication rate and high success rate. In regard to continence and establishment of adequate capacity at low pressure, with in the study period upper tract preservation was excellent. However 10 years follow-up is indicated to confirm our initial results.