正位可控去带盲结肠膀胱加回肠抗反流术

Detenia cecocolon orthotopic neobladder (Report of 20 cases)

目的 :探讨正位可控去带盲结肠膀胱加回肠抗反流术的临床效果。方法 :采用膀胱全切正位可控去带盲结肠膀胱加末段回肠抗反流术治疗膀胱癌 2 0例。结果 :随访 9～ 4 2个月 ,白天均可控制排尿 ,14例夜间能自控排尿 ,6例夜间有尿失禁。尿动力学检查 :12个月贮尿囊平均最大容量 35 0ml,平均最大囊内压 3.16kPa ,剩余尿量为 16ml,平均最大尿流率 19.2ml/s。贮尿囊造影及IVU显示 2例有双侧输尿管反流 ,无输尿管狭窄和肾积水。血电解质及肾功能正常。结论 :正位可控去带盲结肠膀胱加末段回肠抗反流术操作简单 ,并发症少 ,疗效好 。

Purpose:To evaluate the detenia cecocolon orthotopic neobladder.Methods:A detenia cecocolon orthotopic neobladder was constructed for 20 patients with bladder cancer after total cystectomy. Results:Follow up was 9 to 42 months. All patients were continent during the day but only 14 were continent at night. Urodynamic data after 1 year showed a mean capacity of 350 ml for the neobladder and a mean full filling pressure of 30.2 cm water. The residual urine volume was 16 ml. The maximal uroflow rate was good (mean 19.2 ml/sec). Bilateral ureter reflux was found on pouch photography in 2 cases. There has been no evidence of ureter stenosis or impairment of renal function and serum electrolytes have been normal in all. Conclusions:The detenia cecocolon orthotopic neobladder may be an ideal operation for bladder substitution after total cystectomy.