原位阑尾作输出道的可控回结肠膀胱术后远期并发症

Late complications of continent ileocolic reservoir with an unaltered in situ appendix conduit

目的 探讨可控性回结肠膀胱术后远期并发症及其处理方法。 方法 膀胱癌患者30例 ,行回结肠可控膀胱阑尾原位腹壁造口术并进行长期随访观察。随访时间 10 8～ 12 6个月 ,平均118个月。 结果 本组远期并发症包括 :贮尿囊容量过大 5例 ,贮尿囊内结石形成 6例 ,插管导尿困难 4例 ,输尿管梗阻 3例 ,贮尿囊内出血 1例 ,高氯性酸中毒 1例。针对发生的并发症作出相应处理 ,症状均得到控制。 结论 可控性回结肠膀胱阑尾原位腹壁造口术远期疗效可靠 ,但并发症发生率仍较高 ,有待进一步完善。

Objective To evaluate the late complications of continent ileocolic reservoir with an unaltered in situ appendix conduit and the management. Methods Thirty patients with bladder cancer who had undergone the surgery of continent ileocolic diversion with an unaltered in situ appendix conduit were followed up for 108 to 126 months (mean 118 months).The long-term post-operative complications were documented. Results The complications occurred as follows:urinary pouch superdistention in 5 cases,calculus formation in the urinary pouch in 6,difficulty with catheterization in 4,uerteral obstruction in 3,hemorrhage of the pouch in 1 and mild hyperchloremic acidosis in 1.These complications were managed accordingly and good results achieved. Conclusions Although continent ileocolic diversion with an unaltered in situ appendix conduit has a long-term efficacy,the complications occur frequently.The procedure needs further improvement.