【摘要】 目的　探讨全膀胱切除回肠膀胱术后近期再手术的原因。　方法　回顾性分析 81例膀胱肿瘤行膀胱全切回肠膀胱术中 12例近期再手术患者的临床资料。 12例均为男性 ,平均年龄 70岁。膀胱移行细胞癌T2 4例 ,T3 8例 ;G2 7例 ,G3 5例。术后发生粘连性肠梗阻 4例 ,回肠膀胱坏死 2例 ,乙状结肠前列腺窝嵌入打折 2例 ,内疝 2例 ,伤口感染不愈合裂开 2例。　结果　 12例患者术后7～ 32d ,平均 13d内分别行肠管粘连松解术、回肠膀胱重建术、坏死肠管切除术及伤口清创术。术后随访 6～ 12个月 ,平均 7.7个月 ,患者均恢复良好 ,未出现其他并发症。　结论　回肠膀胱术后易发生粘连肠梗阻、回肠膀胱坏死及内疝等并发症 ,完备的围手术期处理、及时妥善的再手术可提高手术效果和患者的生活质量。更多还原

【Abstract】 Objective To analyze the cause of re-operation after radical cystectomy and ileal conduit in early follow-up period in order to improve the efficacy of this operation and reduce postoperative complications. Methods 12 cases from 81 cases of re-operation were studied retrospectively after radical cystectomy and ileal conduit for bladder tumor in early follow-up period.Of the 12 cases,there are 4 cases of T 4,8 cases of T 3,7 cases of G 2,5 cases of G 3.They are all transitional cell carcinoma. Results There were 4 cases of adhesive intestinal obstruction,2 necrosis of ileal conduit,2 adhesive folding of sigmoid colon into prostatic fossa,2 internal hernia and 2 avulsed incision due to infection .All the cases were re-operated nearly the first operation.After the second operation,all the cases were followed 6～12 months,average 7.7 months,the outcome was satisfied. Conclusions The ileal conduit is a kind of ideal methods for urinary diversion and its early complications should be avoided affecting the efficacy of this operation and the quality of life patients.更多还原