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(9 cases reports)

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。

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