原位回肠代膀胱术26例临床分析

Orthotopic ileal neobladder (Report of 26 cases)

目的 :评估 1 3年来根治性膀胱全切术后回肠代膀胱术疗效。方法 :观察 2 6例患者术后可控情况 ,实验室、影像学检查结果以及手术并发症。随访时间 2～ 72个月 ,平均 2 4个月。结果 :4例患者死于肿瘤复发和转移 ,1例术后死亡与肿瘤无关。 2 1例患者白天可控 ;3例出现夜间遗尿 ;1例尿潴留 ;2例术后出现膀胱瘘并行修补术 ,但一直尿失禁 ;1例术后出现腹股沟斜疝。结论 :原位回肠代膀胱术是一种可控效果好 。

Purpose:To evaluate the treatment outcome of orthotopic ileal neobladder after radical cystectomy.Methods:26 cases of orthotopic ileal neobladder have been followed up for 2-72 months with a mean of 24 months.The follow up studies included the observation of urine continent, any surgical complication,radiologic examinations,and laboratory examinations.Results:4 patients died of cancer metastasis and recurrence.1 patient died of disease not being related to the carcinoma.21 patients had continence during daytime and 3 patients had noctural enuresis.Only one patient developed urinary retention.Two patients received the repair of reservoir fistula after operation and then had incontinence all day.One patient underwent surgical management for hernia.Conclusions:The orthotopic ileal neobladder should be a good surgical method with less complications and satisfactory continence.