去带盲升结肠可控膀胱术临床研究

Clinical study of detenia cecal-ascending colon continent cutaneous urinary reservoir

目的 建立一种操作简单、并发症少、较理想的可控性尿流改道术。 方法 对 2 6例膀胱癌等肿瘤患者行根治性膀胱切除术后 ,游离截取 15～ 2 0cm盲升结肠 ,间隔 0 5～ 1 0cm切断结肠带 ,建成去带盲升结肠可控膀胱并开口于脐部。 结果 随访 2～ 5 1个月 ,可控效果好 ,并发症少 ,术后 6个月 3～ 6h放尿 1次 ,每次尿量为 35 0～ 6 0 0ml。尿动力学显示 :最大充盈压为 (5 9± 2 4)cmH2 O ,输出道最大闭合压为 (10 4± 34 )cmH2 O。

Objective To construct a good continent urinary diversion which is easy to be performed and has a low incidence of complications. Methods 26 cases of bladder cancer were given radical cystectomy before the cecal ascending colon was exclused and 15 20 cm of the cecal ascending colon was isolated. The colon teniae were then incised at the interval of 0 5 1 0 cm to construct the detenia cecal ascending colon continent urinary diversion open to the umbilicus. Results All the patients were followed up for 21 1±10 1 months. Reliable continence was achieved in all with a low incidence of complications. The capacity of the reservoirs reached 350 600 ml 6 month after operation. Self catherizations were carried out every 3 to 6 hours, Urodynamic data showed a mean maximum filling pressure of 58 7±24 5 cmH 2O, and a mean maximum urethral (efferent) closure pressure of 104 3±33 8 cmH 2O. Conclusion Detenia cecal ascending colon continent urinary diversion is an ideal method.