去带乙状结肠原位膀胱术50例临床分析

Detenial sigmoid neobladder report of 50 cases

目的 探讨去带乙状结肠原位膀胱术的临床疗效。 方法 膀胱癌 5 0例 ,其中男 4 1例 ,女 9例 ;年龄 35～ 82岁 ,平均 6 3岁。均采用根治性膀胱切除及去带乙状结肠新膀胱术治疗。 结果 5 0例患者随访 6～ 2 9个月 ,平均 18.6个月。患者血Cr、BUN均正常 ,未出现酸中毒。膀胱造影仅2例出现单侧输尿管返流。白天可自控排尿 4 5例 (90 % ) ,夜间尿失禁 10例 (2 0 % ) ,8例可通过夜间唤醒控制。新膀胱容量 2 2 0～ 5 5 0ml(平均 35 0ml) ,新膀胱充盈时最大压力 15～ 5 5cmH2 O(平均 35cmH2 O ,1cmH2 O =0 .0 98kPa)。 结论 该术式操作简单 ,并发症少 ,疗效可靠 ,患者原位排尿 ,值得临床推广运用。

Objective To investigate the clinlic therapeutic result of detenial sigmoid neobladder after radical cystectomy. Methods 50 patients with bladder cancer (41 males and 9 females;age range from 35 to 82 years) were admitted and underwent radical cystectomy and detenial sigmoid neobladder. Results All the 50 patients were followed up for a mean of 18.6 months(range from 6 to 29 months).The blood Cr and BUN levels were both in the normal range without acidosis in all the cases.Only 2 had unilateral ureteral urine reflux during cystography.Of the 50 patients 45 cases(90%) achieved continence during daytime;10 cases(20%) were incontinent at night,but 8 of the 10 cases could control urination by being woken up at night.The capacity of the neobladder was 220 to 550 ml with a mean of 350 ml and the maximal pressure of the neobladder during filling was 15 to 55 cmH 2O(1 cmH 2O=0.098 kPa) with a mean of 35 cmH 2O. Conclusions As a simple operation the detenial sigmoid neobladder can be performed easily with less complications and more reliable results.This operation may be generally applied in clinical practice.