可控性盲升结肠膀胱术75例疗效观察

The curative effect observation of Indiana pouch procedure: A report of 75 cases

目的评价全膀胱切除术后盲升结肠膀胱术的远期疗效。方法对Indiana-pouch法进行了改进:即输尿管末端做成乳头,乳头植入贮尿囊内并>2.0cm,粘膜下隧道等三重抗返流措施。同时对贮尿囊粘膜处理方法亦进行了改进。结果75例病人半年后贮尿囊容量在520～900ml,平均610ml,充盈时平均囊内压为10.4±2.8cmHO2;贮尿囊造影显示:造影剂未见输尿管内返流;静脉肾盂造影(IVU)示肾盂及输尿管无积水。结论可控性盲升结肠膀胱术具有操作容易、省时、贮尿量满意、囊内压低、插管易控制、术后并发症少等优点。

Objective To assess the long term effect of indiana pouch procedure after total cystectomy. Methods The Indiana-pouch procedure had been improved as follows: after the end of ureter being made as nipple-like, it was implanted into the pouch with a tunnel way under bladder mucous for more than 2.0cm at least. So there were double ways to anti-reflux of urine. The process of pouch mucous was ameliorated too. Result After being follow-ups of half a year, the mean capacity of pouch was 610ml (520-900ml) and the mean filling pressure of the pouch was 10.4+2.8cmH2O. There was no evidence of ureter reflux and hydroneophrosis. Conclusions Indiana pouch procedure is fairly good for urinary diversion with high capacity, low pressure, minimal complications and catheteritation being easy.