腹腔镜全膀胱切除原位W形回肠代膀胱术的疗效评价

Clinical evaluation of laparoscopic radical cystectomy with orthotopic "W" ileal neobladder

目的总结腹腔镜全膀胱切除原位W形回肠代膀胱术的疗效。方法 11例浸润性膀胱癌患者行腹腔镜下全膀胱切除加原位W形回肠代膀胱术,记录手术时间、出血量、术后控尿功能恢复时间等。结果平均手术时间及出血量分别为7.5±0.8 h、610.3±12.5 m L,术后30~42 d均恢复控尿功能。术后21 d静脉尿路造影未见输尿管返流及梗阻。术后3个月尿动力检查显示尿流曲线呈持续型8例,间歇型3例。结论腹腔镜膀胱全切除原位W形回肠代膀胱术安全可行,控尿效果良好。

Objective To summarize the therapeutic efficacy of ＂W＂-shaped orthotopic ileal neobladder following laparos- copic radical cystectomy （LRC）. Methods Eleven patients with invasive bladder carcinoma underwent LRC with ortbotopic ＂W＂ ileal neobladder. The operation time, blood loss, and urinary continence function were recorded. Results The mean operation time, blood loss and recovery time of urinary continence function were 7.5± 0.8 h, 610.3±12.5 mL, 30-42 d, respectively. Intravenous urography showed no vesicoureteral reflux and ureter obstruction after 21 days. Urodynamic study demonstrated that uroflow curve was continuous in 8 cases and intermittent in 3 cases after 3 months. Conclusion LRC with orthotopic ＂W＂ ileal neobladder is safe and feasible, which provides a satisfactory urinary continence function.