【摘要】 目的　总结输尿管口附近膀胱肿瘤的手术治疗经验。　方法　需行输尿管再植的膀胱肿瘤患者 4 2例 ,随机分为两组 :A组 2 0例 ,绕输尿管口膀胱壁舌状切除结合改良Huctch Ⅱ输尿管移植 ;B组 2 2例 ,膀胱外寻找并离断输尿管 ,膀胱部分切除术后将输尿管再植于膀胱。对两组手术时间、手术失血量、术后引流量、近期并发症、膀胱输尿管返流、输尿管梗阻及肿瘤复发率进行对比分析。　结果　A组手术时间 (6 0 .5± 18.5 )min、手术失血量 (30 .7± 12 .4 )ml、术后引流量 (5 0 .6± 17.8)ml;B组手术时间 (15 0 .9± 2 2 .4 )min、手术失血量 (2 2 0 .5± 2 8.2 )ml、术后引流量 (2 80 .6± 5 8.9)ml;以上三项指标两组之间差异有显著性意义 (P <0 .0 0 1)。近期并发症A组 2例 ,B组 8例。两组间比较差异有显著性意义 (P <0 .0 5 ) ;膀胱输尿管返流、输尿管梗阻及肿瘤复发率两组比较差异无显著性 (P >0 .0 5 )。　结论　绕输尿管口膀胱舌状切除结合改良Huctch Ⅱ输尿管移植手术效果良好 ,手术并发症少 ,操作简单 ,值得推荐。更多还原

【Abstract】 Objective To evaluate the surgical treatment of bladder cancer near ureteral orifice. Methods 42 cases of bladder cancer requiring ureteral reimplantation were divided into two groups at random:20 cases in group A:tongue-shaped incision of bladder wall around ureteral orifice was performed to modify Huctch-Ⅱ ureter implantation and 22 cases in group B:severing the ureter just outside the bladder,the ureter was then implanted into the bladder after partial cystectomy.Duration of the procedure,blood loss,amount of post-operation drainage,early complication,bladder ureter reflux,ureter obstruction,and cancer recurrence rate were studied and compared. Results In group A,the surgery took 60.5±18.5 min,blood loss amounted to 50.6±12.8 ml and the post-operative drainage 50.6±17.8 ml.In group B,the operation needed 150.9±22.4 min,the blood loss amounted to 220.5±28.2ml and post-operative drainage 280.6±58.9 ml.All the above three indexes showed siginificant difference between the 2 groups (P<0.001).In group A,2 cases had early complication and in group B 8 (P<0.05).There were no obvious differences for bladder ureter reflux,ureter obstruction and cancer recurrence rate(P>0.05). Conclusions Tongue-shaped incision of bladder wall around the ureteral orifice better with less complication,technically easier and worth recommendation.更多还原