阑尾输出道盲升结肠可控膀胱术(附9例报告)

Continent cecum-ascending colic bladder with unaltered in situ appendix conduit-areport 9 cases

目的 改进膀胱癌患者膀胱全切后贮尿囊及排尿情况。方法 根治性全膀胱切除加阑尾输出道盲升结肠带切断或去管简单重建贮尿囊可控膀胱术。结果 术后随访 2～ 19个月 ,两种术式建立的贮尿囊顺应性均良好 ,平均容积为 3 0 2ml ,内压为 8cmH2 O ,阑尾输出道最大压力为 71cmH2 O ,平均 62cmH2 O ,尿控良好 ,自行导尿容易。结论 阑尾输出道盲升结肠可控膀胱术 ,操作相对简单 ,是一种较理想的尿路改道方法 ,具有较好的临床应用价值。

Objective To improve the clinical results of continent cecum ascending colic bladder with unaltered in situ appendix conduit following total cystectomy.Methods 9 patients with bladder cancer were treated with this technique by the incision of the ascending colic ligament or cutting out the wall of ascending colon to recondition urine reservior following total cystectomy.Results The patients had been followed up for 2～19 months.Compliance of the reservoir was satisfying.The mean capacity of the urine reservoir and intrareservoir pressure were 302ml and 8cm H 2O respectively.The maximum efferent conduit pressure was 71 cmH 2O,mean being 62cmH 2O.Continence of urination was excellent and catheterization was satisfying.Conclusion The technique of continent cecum ascending colic bladder with unaltered in situ appendix conduit provides a relatively simple manner for operation with excellent continence.It is highly recommended for clinical application.